Subject: OAR 461-001-0000 about defined terms used in rules
about public assistance, medical assistance, supplemental nutrition assistance
programs and OAR 461-115-0140 about the authorized representative or alternate
payee in the Supplemental Nutrition Assistance Program are being amended to
update and revise references to administrators and program managers.

OAR 461-025-0310
about hearing requests is being amended to clarify that a hearing request may
be submitted for a claimant by an authorized representative or an attorney.

OAR 461-025-0371
about orders issued by the Office of Administrative Hearings (OAH) and the
Department in contested cases is being amended to streamline the process the
rule requires for varying the type of order the Department requests. This rule
is also being amended to add the option of a proposed and final order as
described in OAR 137-003-0645(4), to lengthen and clarify the timeline for
submitting written exceptions to the Department, and to conform to current
practices.

OAR 461-110-0370
about filing groups, 461-155-0190 about income and payment standards, and
461-160-0430 about income deductions are being amended to implement the annual
increase in the standards for the SNAP Program. OAR 461-160-0420 is being
amended to reflect the annual change in the Standard Utility Allowances. Each
year Oregon surveys utility companies and the general public about increases in
utility costs. The utility allowances are derived from these surveys and
approved by the Food and Nutrition Service in the SNAP Program State Plan.
There are four utility allowances. The full utility allowance (FUA) is for
those households that have heating and cooling costs. The limited utility
allowance (LUA) is for those households with more than one non-heating/cooling
utility cost. The individual utility allowance (IUA) is for those households
with a single non-heat cost. The single utility allowance (TUA) is for those
households with only a telephone cost. These rules are also being amended to
clarify when amounts listed are monthly amounts.

OAR 461-115-0071
related to the General Assistance (GA) and General Assistance Medical (GAM)
Programs (currently not funded), Oregon Supplemental Income Program Medical
(OSIPM, medical assistance for seniors and persons with disabilities) and
Qualified Medicare Beneficiary (QMB) programs is being amended to no longer
require that both adults must sign the application for benefits when married
spouses live together. This rule is also being amended to remove references to
the Oregon Supplemental Income Program (OSIP, cash assistance to seniors and
persons with disabilities).

OAR 461-115-0232
is being adopted to allow the Department to close cases that do not comply with
required interview during month 12 of their 24 month certification. This rule
will only affect households that have been approved for 24 months.

OAR 461-115-0450
is being amended to allow households with all adult members who are elderly or
have disability, and in which there is no earned income to be certified for 24
months for the Supplemental Nutrition Assistance Program (SNAP), as permitted
by The Food and Nutrition Act of 2008.

OAR 461-120-0510
about age requirements for clients to receive benefits in various programs is
being amended for the Oregon Supplemental Income Program-Aid to the Disabled
program (OSIP-AD, cash assistance for persons with disabilities) to change the
age requirement — from 18 years or older and under the age of 65 —
to under the age of 65. This rule is also being amended to add cross-references
to defined terms.

OAR 461-125-0170 about
when deprivation exists based on the unemployment or underemployment of a
primary wage earner in the Temporary Assistance for Needy Families (TANF) and
Medical Assistance Assumed programs, in response to recent legislation (House
Bill 2049, 2011), is being amended to revise the criteria for determining
deprivation for a primary wage earner separated from his or her most recent
employment. This rule is also being amended to make permanent temporary rule
changes adopted on July 1, 2011.

OAR 461-130-0310
about how the Department assigns clients to one or more participation
classifications in the Post-Temporary Assistance for Needy Families
(Post-TANF), Pre-Temporary Assistance for Needy Families (Pre-TANF), Refugee
(REF), Supplemental Nutrition Assistance Program (SNAP), and Temporary
Assistance for Needy Families (TANF) programs is being amended to expand the
list of which Post-TANF, Pre-TANF, or TANF program clients are exempt from
employment program participation and potential disqualification from program
benefits. This rule is also being amended to make permanent the temporary rule
changes adopted on July 1, 2011.

OAR 461-135-0070
about the specific eligibility requirements in the Medical Assistance Assumed
(MAA), Medical Assistance to Families (MAF) and Temporary Assistance for Needy
Families (TANF) programs is being amended in response to recent legislation
(House Bill 2049 (2011)) to revise the definition of “most recent employment”.
This rule also is being amended to restate when a need group (the individuals
whose basic and special needs are used in determining eligibility and benefit
level) is not eligible for TANF program benefits due to a caretaker relative in
the need group being separated from his or her most recent employment. This
rule is also being amended to make permanent the temporary rule changes adopted
on July 1, 2011.

OAR 461-135-0570
is being amended to allow individuals awarded state or federal work-study to be
considered eligible students in the SNAP program when it is found the school
they are attending does not have any work-study jobs available. This rule is
also being amended to allow individuals receiving Unemployment Compensation
through the Employment Department or participating in any of the following to
be considered to meet the student criteria: The Trade Readjustment Allowance
(TRA) program serving displaced workers under the Trade Act; The Training
Unemployment Insurance (TUI) program; The Self-Employment Assistance (SEA)
program; The Apprenticeship Program (APT); regular UC benefits through the
Employment Department (ED).

OAR 461-135-1110
about when a student enrolled in higher education is eligible or ineligible for
the Oregon Health Plan - Adults program (OHP-OPU, which provides coverage for
adults who qualify under the 100 percent income standard) is being amended in
response to a recent change in federal guidelines to revise the definition for
the term “meets the requirements for a Pell grant” and update the school years
that apply. This rule also needs to be amended to make permanent the temporary
rule amendment adopted on July 1, 2011.

OAR 461-155-0610
about special needs payments for moving costs made to certain General
Assistance (GA is currently not funded), Oregon Supplemental Income Program
(OSIP, assistance to seniors and people with disabilities) and Oregon
Supplemental Income Program Medical (OSIPM) program clients is being amended to
clarify that the client must be the age of 18 or older.

OAR 461-155-0660
about shelter payments made to certain Oregon Supplemental Income Program
(OSIP, assistance to seniors and people with disabilities) and Oregon
Supplemental Income Program Medical (OSIPM) program clients is being amended to
clarify that the client must be the age of 18 or older.

OAR 461-155-0680
about telephone allowance payments made to certain Oregon Supplemental Income
Program Medical (OSIPM, assistance to seniors and people with disabilities)
program clients is being amended to clarify that the client must be the age of
18 or older.

OAR 461-160-0620
about the income deductions allowed in and the calculation of an Oregon
Supplemental Income Program Medical (OSIPM) client’s liability when the client
is receiving long-term care or waivered services is being amended to reflect
the federal changes effective July 1, 2011 in the amounts used when calculating
the maintenance needs allowance and the dependent income allowance deducted
from the income of an institutionalized spouse. This rule is also being amended
to make permanent a temporary rule change adopted July 1, 2011.

OAR 461-190-0199
about the operation of and the eligibility, selection, and participation
requirements for the Parents as Scholars (PAS) component of the Job Opportunity
and Basic Skills (JOBS) program, in response to recent legislation (House Bill
2049, 2011), is being amended to state which clients, effective July 1, 2011,
may participate in PAS and how the Department manages applications for PAS
received after June 30, 2011.This rule is also being amended to make permanent
the temporary rule amendment adopted on July 1, 2011.

OAR 461-190-0211
about case plan activities and standards for support service payments in the
JOBS, Post-TANF, Pre-TANF, REF, SFPSS, TA-DVS, and TANF programs is being
amended to set limits to who can participate in a case plan activity, identify
available activities and support services for those activities, describe how
the Department determines employability in order to place participants into
appropriate activities and support services, describe the activities that
qualify for support services and the amount of support services available. This
rule sets up a more limited JOBS program, consistent with budget constraints,
following earlier Department actions that closed most activities and support
services set up under earlier eligibility criteria. This rule is also being
amended to make permanent the changes adopted by temporary rule on July 1,
2011.

OAR 461-190-0212
is being adopted to indicate which Job Opportunity and Basic Skills (JOBS)
program activities and services ended June 30, 2011. This rule is also being
adopted to state that JOBS program support service payments received by the
client to assist in participation in one or more of the identified activities
or services ended June 30, 2011. This program reduction affected clients who
are participating in the JOBS program while receiving Pre-TANF, TANF,
Post-TANF, Refugee, SFPSS, or TA-DVS program benefits. Without this new rule,
the Department would fully deplete resources available for the JOBS program,
and be unable to set up a more limited program consistent with restricted
funding. This rule is also being adopted to make permanent the temporary rule
adopted on June 2, 2011 and subsequently amended on June 27, 2011.

OAR 461-193-1190
about refugee project noncooperation is being repealed. The Refugee Case
Service Project (RCSP) has both Refugee Program (REF) and Temporary Assistance
for Need Families (TANF) participants. REF and TANF noncooperation and job
discharge provisions are currently found in OAR Chapter 461 Division 130.

OAR 461-195-0501
about how the Department defines and categorizes overpayments (benefits paid to
a client in error, that the Department generally attempts to recover from the
client) for programs administered under chapters 410, 411, and 461 of the
Oregon Administrative Rules is being amended in response to an Oregon
Legislature Emergency Board directive (September 23, 2010) to expand what
constitutes a child care overpayment and a client error overpayment.

OAR 461-195-0521
is being amended to correctly state in the Temporary Assistance to Needy
Families (TANF) program the Department of Justice (DOJ) retains support. The
current rule states this is done in the Department of Human Services (DHS). The
amendment is needed to correctly state the support is retained by DOJ for TANF
programs. This rule is also being amended to specify the overpayment
calculation when the client was not eligible for Breast and Cervical Cancer
Medical (BCCM), Continuous Eligibility for OHP-CHP (CEC), Continuous
Eligibility for Medicaid (CEM), Extended Medical Assistance (EXT), Medical
Assistance Assumed (MAA), Medical Assistance to Families (MAF), Oregon Health
Plan (OHP-CHP, OPC, OPP, OPU, OP6), Oregon Supplemental Income Program Medical
(OSIPM), Qualified Medical Beneficiaries (QMB), Refugee Assistance Medical
(REFM) or Medical Assistance to Children in Substitute or Adoptive Care (SAC)
programs, but during the period in question was eligible for another program.
The current rule does not specify the medical programs to which the calculation
applies. The amendment is needed to clarify the calculation applies to the
BCCM, CEC, CEM, EXT, MAA, MAF, OHP (CHP, OPC, OPP, OPU, OP6), OSIPM, QMB, REFM
and SAC programs only.

OAR 461-195-0541
is being amended to conform to federal regulations at 7 CFR 273.18 which
eliminated a sponsor of a non-citizen household member from liability to repay
a Supplemental Nutrition Assistance Program (SNAP) overpayment. This amendment
is needed to remove a sponsor of a non-citizen household member from the list
of persons liable for repayment of a SNAP overpayment. The rule is also being
amended to clarify that when the Department determines there is a client
overpayment in the child care program, any other adult required to be in the
filing group is also liable to repay the overpayment. This amendment is needed
to state any other adult required to be in the filing group is liable for
repayment of a client overpayment in the child care program.

OAR 461-195-0621
is being amended to clarify when an intentional program violation (IPV) is
established against a person in the Temporary Assistance for Domestic Violence
Survivors (TA-DVS) program. The current rule states an IPV is established
against a person through a contested case hearing or a waiver of the right to
hearing. The amendment is needed to state that an IPV is also established
against a person in the TA-DVS program by a state or federal court.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-001-0000

Definitions for Chapter 461

Defined terms are often italicized throughout this
chapter of rules. If a defined term is accompanied by a cross-reference to a
rule defining the term, subsequent usages of that term in the same rule refer
to the same definition cross-referenced earlier in the rule. In this chapter of
rules, unless the context indicates otherwise:

(1) A reference to Division, Adult and Family Services
Division (or AFS), Senior and Disabled Services Division (or SDSD), or any
other agency formerly part of the Department of Human Services shall be taken
to mean the Department of Human Services (DHS), except that the rule in which
reference occurs only regulates programs covered by chapter 461 of the Oregon
Administrative Rules.

(2) “Address Confidentiality Program” (ACP) means a
program of the Oregon Department of Justice, which provides a substitute
mailing address and mail forwarding service for ACP participants who are
victims of domestic violence, sexual assault, or stalking.

(3) “Adjusted income” means the amount determined by
subtracting income deductions from countable income (see OAR 461-140-0010).
Specific rules on the deductions are found in division 461-160.

(4) “Adoption assistance” means financial assistance
provided to families adopting children with special needs. Adoption assistance
may be state or federally funded. Federal adoption assistance is authorized by
the Adoption Assistance and Child Welfare Act of 1980 (Pub. L. No. 96-272, 94
Stat. 500 (1980)). State adoption assistance is authorized by ORS 418.330 to
418.335.

(5) “Assets” mean income and resources.

(6) “Basic decision notice” means a decision notice
mailed no later than the date of action given in the notice.

(7) “Branch office” means any Department or AAA (Area
Agency on Aging) office serving a program covered by this chapter of rules.

(8) “Budgeting” means the process of calculating the
benefit level.

(9) “Budget month” means the calendar month from which
nonfinancial and financial information is used to determine eligibility and
benefit level for the payment month.

(10) “Cafeteria plan” means a written benefit plan
offered by an employer in which:

(a) All participants are employees; and

(b) Participants can choose, cafeteria-style, from a
menu of two or more cash or qualified benefits. In this context, qualified
benefits are benefits other than cash that the Internal Revenue Services does
not consider part of an employee’s gross income. Qualified benefits include,
but are not limited to:

(11) “Capital asset” means property that contributes
toward earning self-employment income, including self-employment income from a
microenterprise, either directly or indirectly. A capital asset generally has a
useful life of over one year and a value, alone or in combination, of $100 or
more.

(12) “Caretaker” means an individual who is responsible
for the care, control, and supervision of a child. The status of caretaker ends
once the individual no longer exercises care, control, and supervision of the
child for 30 days.

(13) “Caretaker relative” means a caretaker who meets
the requirements of one of the following subsections:

(a) Is one of the following relatives of the dependent
child:

(A) Any blood relative, including those of half-blood,
and including first cousins, nephews, or nieces, and individuals of preceding
generations as denoted by prefixes of grand, great, or great-great.

(B) Stepfather, stepmother, stepbrother, and
stepsister.

(C) An individual who legally adopts the child and any
individual related to the individual adopting the child, either naturally or
through adoption.

(b) Is or was a spouse of an individual listed in
subsection (a) of this section.

(c) Met the definition of caretaker relative under
subsection (a) or (b) of this section before the child was adopted
(notwithstanding the child’s subsequent adoption).

(14) “Certification period” means the period for which
a client is certified eligible for a program.

(15) “Child” includes natural, step, and adoptive
children. The term child does not include an unborn.

(a) In the ERDC program, a child need not have a
biological or legal relationship to the caretaker but must be in the care and
custody of the caretaker, must meet the citizenship or alien status
requirements of OAR 461-120-0110, and must be:

(A) Under the age of 18; or

(B) Under the age of 19 and in secondary school or
vocational training at least half time.

(b) In the GA, GAM, and OSIP programs, a child is an
individual under the age of 18.

(c) In the OHP program, child means an individual,
including a minor parent, under the age of 19.

(d) In the OSIPM and QMB programs, child means an
unmarried individual living with a parent who is:

(A) Under the age of 18; or

(B) Under the age of 22 and attending full time
secondary, post secondary or vocational-technical training designed to prepare
the individual for employment.

(16) “Community based care” is any of the following:

(a) Adult foster care — Room and board and 24 hour
care and services for the elderly or for disabled people 18 years of age or
older. The care is contracted to be provided in a home for five or fewer
clients.

(b) Assisted living facility — A program
approach, within a physical structure, which provides or coordinates a range of
services, available on a 24-hour basis, for support of resident independence in
a residential setting.

(c) In-home Services — People living in their
home receiving services determined necessary by the Department.

(d) Residential care facility — A facility that
provides residential care in one or more buildings on contiguous property for
six or more individuals who have physical disabilities or are socially
dependent.

(e) Specialized living facility — Identifiable
services designed to meet the needs of individuals in specific target groups
which exist as the result of a problem, condition or dysfunction resulting from
a physical disability or a behavioral disorder and require more than basic
services of other established programs.

(f) Independent choices — In-Home Services
program wherein the participant is given cash benefits to purchase
self-directed personal assistance services or goods and services provided
pursuant to a written service plan (see OAR 411-030-0020).

(17) “Continuing benefit decision notice” means a
decision notice that informs the client of the right to continued benefits and
is mailed in time to be received by the date benefits are, or would be,
received.

(18) “Countable” means that an available asset (either
income or a resource) is not excluded and may be considered by some programs to
determine eligibility.

(19) “Custodial parents” mean parents who have physical
custody of a child. Custodial parents may be receiving benefits as dependent
children or as caretaker relatives for their own children.

(20) “Decision notice” means a written notice of a
decision by the Department regarding an individual’s eligibility for benefits
in a program.

(a) An individual who is not a caretaker relative of a
child in the household, is unmarried or married but separated, and is under the
age of 18, or 18 years of age and a full time student in secondary school or
the equivalent level of vocational or technical training; or

(b) A minor parent whose parents have chosen to apply
for benefits for the minor parent. This does not apply to a minor parent who is
married and living with his or her spouse.

(23) “Disability” means:

(a) In the SNAP program, see OAR 461-001-0015.

(b) In the REF, SFPSS, TA-DVS, and TANF programs, for
purposes other than determining eligibility:

(A) An individual with a physical or mental impairment
that substantially limits the individual’s ability to meet the requirements of
the program; or

(B) An individual with a physical or mental impairment
that substantially limits one or more major life activities, a record of such
impairment, or who is regarded as having such an impairment as defined by the
Americans with Disabilities Act (42 USC 12102; 28 CFR 35.104).

(24) “Domestic violence” means the occurrence of one or
more of the following acts between family members, intimate partners, or
household members:

(c) Committing sexual abuse in any degree as defined in
ORS 163.415, 163.425 and 163.427.

(d) Using coercive or controlling behavior.

(25) “Domestic violence shelters” are public or private
nonprofit residential facilities providing services to victims of domestic
violence. If the facility serves other people, a portion must be used solely
for victims of domestic violence.

(26) ELA means Express Lane Agency: A public agency
identified in the State Medicaid Plan or State CHIP Plan as an agency capable
of making determinations regarding one or more eligibility requirements in the
OHP-OPC, OHP-CHP, or HKC programs.

(27) ELE means Express Lane Eligibility: In the HKC,
OHP-CHP, and OHP-OPC programs, the Department’s option to rely on a
determination, made within a reasonable period, by an ELA finding that a child
satisfies the requirements for OHP-CHP or OHP-OPC program eligibility. ELE
qualifies a child for medical assistance benefits based on a finding from
another public agency, even when the other agency’s eligibility methodology
differs from that ordinarily used by the Department to determine HKC, OHP-CHP,
and OHP-OPC program eligibility.

(28) “Electronic application” is an application
electronically signed and submitted through the internet.

(29) “Eligibility” means the decision as to whether an
individual qualifies, under financial and nonfinancial requirements, to receive
program benefits.

(30) “Equity value” means fair market value minus
encumbrances.

(31) “Fair market value” means the amount an item is
worth on the open market.

(32) “Family stability” in the JOBS, Pre-TANF,
Post-TANF, SFPSS, TA-DVS, and TANF programs means the characteristics of a
family that support healthy child development, including parental mental
health, drug and alcohol free environment, stable relationships, and a
supportive, flexible, and nurturing home environment.

(33) “Family stability activity” in the JOBS, Pre-TANF,
Post-TANF, SFPSS, TA-DVS, and TANF programs means an action or set of actions
taken by the client, as specified in a case plan, intended to promote the
ability of one or both parents to achieve or maintain family stability.

(34) “Financial institution” means a bank, credit
union, savings and loan association, investment trust, or other organization
held out to the public as a place receiving funds for deposit, savings,
checking, or investment.

(36) “Income producing property” means any real or
personal property that generates income for the financial group. Examples of
income producing property are:

(a) Livestock, poultry, and other animals.

(b) Farmland, rental homes (including a room or other
space in the home or on the property of a member of the financial group),
vacation homes, condominiums.

(37) “Initial month” of eligibility means any of the
following:

(a) In all programs, the first month a benefit group
(see OAR 461-110-0750) is eligible for a program benefit in Oregon after a
period during which the group is not eligible.

(b) In all programs except the SNAP program, the first
month a benefit group is eligible for a program benefit after there has been a
break in the program benefit of at least one full calendar month. If benefits
are suspended for one month, that is not considered a break.

(c) In the SNAP program:

(A) The first month for which the benefit group is
certified following any period during which they were not certified to
participate, except for migrant and seasonal farm workers (see OAR
461-001-0015).

(B) For migrant and seasonal farmworkers, the first
month for which the benefit group is certified following any period of one
month or more during which they were not certified to participate.

(d) In the OHP program, the first month of a
redetermination or recertification period.

(e) For a new applicant to the GA, GAM, OSIP, or OSIPM
program living in a nonstandard living arrangement, for the purposes of
calculating the correct divisor in OAR 461-140-0296, the month in which the
client would have been eligible had it not been for the disqualifying transfer
of assets.

(38) “In-kind income” means income in a form other than
money (such as food, clothing, cars, furniture, and payments made to a third
party).

(39) “Legally married” means a marriage uniting a man
and a woman according to the provisions of either:

(a) The statutes of the state where the marriage
occurred;

(b) The common law of the state in which the man and
woman previously resided while meeting the requirements for common law marriage
in that state; or

(c) The laws of a country in which the man and woman
previously resided while meeting the requirements for legal or cultural
marriage in that country.

(40) “Life estate” means the right to property limited
to the lifetime of the individual holding it or the lifetime of some other
individual. In general, a life estate enables the owner of the life estate to
possess, use, and obtain profits from property during the lifetime of a
designated individual while actual ownership of the property is held by another
individual. A life estate is created when an individual owns property and then
transfers ownership to another individual while retaining, for the rest of his
or her life, certain rights to that property. In addition, a life estate is
established when a member of the financial group (see OAR 461-110-0530)
purchases a life estate interest in the home of another individual.

(41) “Lodger” means a member of the household group
(see OAR 461-110-0210) who;

(a) Is not a member of the filing group; and

(b) Pays the filing group for room and board.

(42) “Long term care” means the system through which
the Department provides a broad range of social and health services to eligible
adults who are aged, blind, or have disabilities for extended periods of time.
This includes nursing homes and state hospitals (Eastern Oregon and Oregon
State Hospitals).

(43) “Lump-sum income” means income received too
infrequently or irregularly to be reasonably anticipated, or received as a
one-time payment. Lump-sum income includes:

(a) Retroactive benefits covering more than one month,
whether received in a single payment or several payments.

(b) Income from inheritance, gifts, winnings, and
personal injury claims.

(44) “Marriage” means the union of a man and a woman
who are legally married.

(45) “Microenterprise” means a sole proprietorship,
partnership, or family business with fewer than five employees and capital
needs no greater than $35,000.

(46) “Minor parent”, in the ERDC, EXT, MAA, MAF, REF,
REFM, and TANF programs, means a parent under the age of 18.

(47) “Nonstandard living arrangement” is defined as
follows:

(a) In the GA, GAM, OSIP, OSIPM, and QMB programs, a
client is considered to be in a nonstandard living arrangement when the client
is applying for or receiving services in any of the following locations:

(A) A nursing facility in which the client receives
long-term care services paid with Medicaid funding, except this subsection does
not apply to a Medicare client in a skilled-stay nursing facility.

(B) An intermediate care facility for the mentally
retarded (ICF/MR).

(C) A psychiatric institution, if the individual is not
yet 21 years of age or has reached the age of 65.

(D) A community based care (see section (17) of this
rule) setting, except a State Plan Personal Care (SPPC) setting is not
considered a nonstandard living arrangement.

(b) In all programs except GA, GAM, OSIP, OSIPM, and
QMB, nonstandard living arrangement means each of the following locations:

(A) Foster care.

(B) Residential Care facility.

(C) Drug or alcohol residential treatment facility.

(D) Homeless or domestic violence shelter.

(E) Lodging house if paying for room and board.

(F) Correctional facility.

(G) Medical institution.

(48) “Ongoing month” means one of the following:

(a) For all programs except the OHP and SNAP programs,
any month following the initial month of eligibility, if there is no break in
the program benefit of one or more calendar months.

(b) For the OHP and SNAP programs, any month in the
certification period following the initial month of eligibility.

(49) “Parent” means the biological or legal (step or
adoptive) mother or father of an individual or unborn child.

(a) If the mother lives with a male and either she or
the male claims that he is the father of the child or unborn, and no one else
claims to be the father, he is treated as the father even if paternity has not
been legally established.

(b) A stepparent relationship exists if:

(A) The individual is legally married to the child’s
biological or adoptive parent; and

(B) The marriage has not been terminated by legal
separation, divorce, or death.

(c) A legal adoption erases all prior legal and blood
relationships and establishes the adoptive parent as the legal parent. However,
the biological parent is also considered a parent if both of the following are
true:

(A) The child lives with the biological parent; and

(B) The legal parent (the adoptive parent) has given up
care, control, and supervision of the child.

(50) “Payment month” means, for all programs except EA,
the calendar month for which benefits are issued.

(51) “Payment period” means, for EA, the 30-day period
starting with the date the first payment is issued and ending on the 30th day
after the date the payment is issued.

(52) “Periodic income” means income received on a
regular basis less often than monthly.

(53) “Primary person” for all programs except the SNAP
program, means the filing group member who is responsible for providing
information necessary to determine eligibility and calculate benefits. The
primary person for individual programs is as follows:

(a) For the EXT, MAA, MAF, and TANF programs, the
parent or caretaker relative.

(b) For the ERDC program, the caretaker.

(c) For SNAP, see OAR 461-001-0015.

(d) For the GA, GAM, OSIP, OSIPM, and QMB programs, the
client or client’s spouse.

(e) For the OHP, REF, and REFM programs, the applicant,
caretaker, caretaker relative, or parent.

(54) “Qualified Partnership Policy” means a long term
care insurance policy meeting the requirements of OAR 836-052-0531 that was
either:

(a) Issued while the client was a resident in Oregon on
January 1, 2008 or later; or

(b) Issued in another state while the client was a
resident of that state on or after the effective date of that state’s federally
approved State Plan Amendment to issue qualified partnership policies.

(55) “Real property” means land, buildings, and
whatever is erected on or affixed to the land and taxed as real property.

(57) “Safe homes” mean private homes that provide a few
nights lodging to victims of domestic violence. The homes must be recognized as
such by the local domestic violence agency, such as crisis hot lines and
shelters.

(59) “Shelter in kind” means an agency or person
outside the financial group (see OAR 461-110-0530) provides the shelter of the
financial group, or makes a payment to a third party for some or all of the
shelter costs of the financial group. Shelter-in-kind does not include
temporary shelter provided by a domestic violence shelter, homeless shelter, or
residential alcohol and drug treatment facilities or situations where no
shelter is being provided, such as sleeping in a doorway, park, or bus station.

(60) “Sibling” means the brother or sister of an
individual. “Blood related” means they share at least one biological or
adoptive parent. “Step” means they are not related by blood, but are related by
the marriage of their parents.

(61) “Spousal support” means income paid (voluntarily,
per court order, or per administrative order) by a separated or divorced spouse
to a member of the financial group (see OAR 461-110-0530).

(62) “Spouse” means an individual who is legally
married to another individual. In the ERDC and SNAP programs, spouse includes
an individual who is not legally married to another, but is presenting
themselves to the community as the husband or wife by:

(a) Representing themselves as husband and wife to
relatives, friends, neighbors, or tradespeople; and

(b) Sharing living expenses or household duties.

(63) “Stable income” means income that is the same
amount each time it is received.

(64) “Standard living arrangement” means a location
that does not qualify as a nonstandard living arrangement.

(65) “Teen parent” means, for TANF and JOBS, a parent
under the age of 20 who has not completed a high school diploma or GED.

(66) “Timely continuing benefit decision notice” means
a decision notice that informs the client of the right to continued benefits
and is mailed no later than the time requirements in OAR 461-175-0050.

(67) “Trust funds” mean money, securities, or similar
property held by a person or institution for the benefit of another person.

(68) “USDA meal reimbursements” mean cash
reimbursements made by the Oregon Department of Education for family day-care
providers who serve snacks and meals to children in their care.

(69) “Variable income” means earned or unearned income
that is not always received in the same amount each month.

(1) A claimant (see OAR 461-025-0305) has the right to
a contested case hearing in the following situations upon the timely completion
of a request for hearing:

(a) Except as provided in subsection (o) of this
section, the Department has not approved or denied a request or application for
public assistance within 45 days of the application.

(b) The Department has not acted timely on an
application as follows:

(A) An application for SNAP program benefits —
within 30 days of the filing date.

(B) An application for a JOBS support service payment
— within the time frames established in OAR 461-115-0190(3).

(c) The Department acts to deny, reduce, close, or
suspend SNAP program benefits, a grant of public assistance, a grant of aid, a
support service payment authorized in the JOBS program by OAR 461-190-0211,
medical assistance, or child care benefits authorized under Division 160 or 165
of this chapter of rules in the ERDC or TANF child care programs. When used in
this subsection, grant of public assistance and grant of aid mean the grant of
cash assistance calculated according to the client’s need.

(d) The Department claims that an earlier public
assistance payment was an overpayment, or that an earlier issuance of SNAP
program benefits was an overissuance.

(e) The claimant claims that the Department previously
underissued public assistance or SNAP program benefits and the Department
denies the claim.

(f) The household disputes its current level of SNAP
program benefits.

(g) The filing group (see OAR 461-110-0370) is
aggrieved by any action of the Department that affects the participation of the
filing group in the SNAP program.

(h) The claimant asks for a hearing to determine if the
waiver of an Intentional Program Violation hearing was signed under duress.

(i) The Department establishes or changes the client’s
premium for the Oregon Health Plan.

(j) In the Pre-TANF program, the Department denies
payment for a basic living expense (see OAR 461-135-0475) or other support
service payment in the JOBS program (see subsection (c) of this section).

(k) In the TA-DVS program, when OAR 461-135-1235
provides a right to a hearing.

(l) A service re-assessment of a client conducted in
accordance with OAR Division 411-015 has resulted in a reduction or termination
of nursing facility services or Waivered Services (defined at OAR
461-001-0030).

(m) The claimant’s benefits are changed to vendor,
protective, or two-party payments.

(n) Department has issued a notice seeking repayment
under ORS 411.892 to an employer participating in the JOBS program.

(o) In the OSIP and OSIPM programs, when the Department
has not approved or denied an application within the time frames established in
OAR 461-115-0190.

(p) The right to a hearing is otherwise provided by
statute or rule.

(2) A client is not entitled to a hearing on the
question of the contents of a case plan (defined in OAR 461-190-0151) unless
the right to hearing is specifically authorized by the Department’s rules. For
a dispute about an activity in the JOBS program, the client is entitled to use
the Department’s re-engagement process (see OAR 461-190-0231). In the TA-DVS
program, a dispute about the contents of a TA-DVS case plan (see OAR
461-135-1205) is resolved through re-engagement if there is no right to a
hearing under OAR 461-135-1235.

(3) A request for hearing is complete:

(a) In public assistance and SNAP programs, when the
Department’s Administrative Hearing Request form (form DHS 443) is:

(A) Completed;

(B) Signed by the claimant, the claimant’s attorney, or
the claimant’s authorized representative (see OAR 461-115-0090); and

(C) Received by the Department.

(b) In the SNAP program, when the Department receives
an oral or written statement from the claimant, the claimant’s attorney, or the
claimant’s authorized representative that the claimant wishes to appeal a
decision affecting the claimant’s SNAP program benefits to a higher authority.

(c) In the case of a provider of child care, when a
written request for hearing from the provider is received by the Department.

(4) In the event a request for hearing is not timely,
the Department will determine whether the failure to timely file a request for
hearing was beyond the reasonable control of the party and enter an order
accordingly. The Department may refer an untimely request to the Office of
Administrative Hearings for a hearing on the question of timeliness.

(5) In the event the claimant has no right to a
contested case hearing on an issue, the Department may enter an order
accordingly. The Department may refer a hearing request to the Office of
Administrative Hearings for a hearing on the question of whether the claimant
has the right to a contested case hearing.

(6) To be timely, a completed hearing request must be
received by the Department not later than:

(a) Except as provided in subsection (b) of this
section, the 45th day following the date of the decision notice (see OAR
461-001-0000) in public assistance and medical programs.

(b) The 90th day following the effective date of the
reduction or termination of benefits in a public assistance program if the
reduction or termination of aid is a result of a JOBS disqualification (see OAR
461-130-0330) or a penalty for failure to seek treatment for substance abuse or
mental health (see OAR 461-135-0085).

(c) The 90th day following the date of the decision
notice in the SNAP program, except:

(A) A filing group may submit a hearing request at any
time within a certification period (see OAR 461-001-0000) to dispute its
current level of benefits.

(B) A filing group may submit a hearing request within
90 days of the denial of a request for restoration of benefits if not more than
twelve months has expired since the loss of benefits.

(d) The 30th day following the date of notice from the
Oregon Department of Revenue in cases covered by ORS 293.250.

(e) In a case described in subsection (1)(h) of this
rule, the request must be made within 90 days of the date the waiver was
signed.

(7) In determining timeliness under section (6) of this
rule, delay caused by circumstances beyond the control of the claimant is not
counted.

(8) In computing the time periods provided by this
rule, see OAR 461-025-0300(1).

(9) In the REF and REFM programs, a client is not
eligible for a contested case hearing when assistance is terminated because the
eligibility time period imposed by OAR 461-135-0900 has been reached. If the
issue is the date of entry into the United States the Department provides for
prompt resolution of the issue by inspection of the individual’s documentation
issued by the US Citizenship and Immigration Services (USCIS) or by information
obtained from USCIS, rather than by contested case hearing.

(1) When the Department refers a contested case under
this division of rules (OAR 461-025) to the Office of Administrative Hearings
(OAH), the Department indicates on the referral:

(a) Whether the Department is authorizing a proposed
order, a proposed and final order (OAR 137-003-0645(4)), or a final order.

(b) If the Department is establishing an earlier
deadline for written exceptions and argument because the contested case is
being referred for an expedited hearing.

(2) When the Department authorizes either a proposed
order or a proposed and final order:

(a) The claimant (see OAR 461-025-0305) or party may
file written exceptions and written argument to be considered by the
Department. The exceptions and argument must be received at the location
indicated in the OAH order not later than the 20th day after service of the
proposed order or proposed and final order, unless subsection (1)(b) of this
rule applies.

(b) Proposed Orders. After OAH issues a proposed order,
the Department issues the final order, unless the Department requests that OAH
issue the final order under OAR 137-003-0655.

(c) Proposed and Final Orders. If the claimant or party
does not submit timely exceptions or argument following a proposed and final
order, the proposed and final order becomes a final order on the 21st day after
service of the proposed and final order unless the Department has issued a
revised order or has notified the claimant or party and OAH that the Department
will issue the final order. When the Department receives timely exceptions or
argument, the Department issues the final order, unless the Department requests
that OAH issue the final order under OAR 137-003-0655.

(3) If in a contested case hearing the Office of
Administrative Hearings is authorized to issue a final order on behalf of the
Department, the Department may issue the final order in the case of default.

(4) A petition by a claimant or party for
reconsideration or rehearing must be filed with the individual who signed the
final order, unless stated otherwise on the final order.

(1) Except as provided in this rule, the filing group
consists of members of a household group (see OAR 461-110-0210) who choose to
apply together or customarily purchase and prepare meals together.

(2) Except as provided in sections (3) and (8) of this
rule, the following household group members must be in the same filing group,
even if they do not customarily purchase and prepare meals together:

(a) Each spouse (see OAR 461-001-0000).

(b) A parent (see OAR 461-001-0000) and his or her
child under age 22 living with the parent.

(c) A household group member and any child under age 18
who lives with and is under parental control of that household group member.
For the purposes of this subsection, “parental control” means the adult is
responsible for the care, control, and supervision of the child or the child is
financially dependent on the adult.

(3) In the following specific situations, the
Department forms a filing group as indicated:

(a) An individual is not included in the filing group
if, during the month the group applied for SNAP program benefits, the
individual received SSI benefits through the state of California. This
exclusion applies only in the month the group applied and, if necessary to meet
notice requirements, in the month following the month the group applied.

(b) An individual is not included in the filing group
if during the month the group applied for SNAP program benefits the individual
received SNAP program benefits in another household and was not the head of
household in the prior household. This exclusion applies only in the month the
group applied and, if necessary to meet notice requirements, in the month
following the month the group applied.

(c) An elderly (see OAR 461-001-0015) individual and
his or her spouse may be considered a separate filing group from others with
whom the elderly individual purchases and prepares meals, if:

(A) The elderly individual is unable to purchase or
prepare food because of a permanent and severe disabling condition; and

(B) The combined income of the other members of the
household group does not exceed the following limit: [Table not included. See
ED. NOTE]

(4) A paid live-in attendant may choose not to be in
the filing group with the recipient of the services provided, unless required
by section (2) of this rule to be in the same filing group.

(5) An individual in foster care, the individual’s
spouse, and each child under age 22 living with the individual are not eligible
to participate in the SNAP program independently of the care or service
provider’s filing group, but may be included in the provider’s filing group if
the provider applies for benefits.

(6) Unless required under section (2) of this rule, the
following household group members may form a separate filing group from other
members of the household group:

(a) A resident of an alcohol or drug treatment and
rehabilitation program certified by the Department for which an employee of the
facility is the authorized representative (see OAR 461-135-0550). A resident’s
spouse in the same facility may be in a separate filing group, but a child of a
resident must be in the same filing group as the resident.

(b) A resident in group living (see OAR 461-001-0015).

(c) A resident of a public or private non-profit
homeless or domestic violence shelter (see OAR 461-135-0510).

(d) An individual who is a resident of federally
subsidized housing for the elderly, an individual with a disability, or blind
recipient of benefits under Title I, II, X, XIV, or XVI of the Social Security
Act.

(7) A member of the household group who pays the filing
group for room and board (lodger) is treated as follows:

(a) A lodger cannot participate in the SNAP program
independently of the household group when the lodger pays a reasonable amount
for room and board. A reasonable amount is:

(A) An amount that equals or exceeds the Thrifty Food
Plan for the individual and anyone in that individual’s filing group (see OAR
461-155-0190(2)), if more than two meals per day are provided; or

(B) An amount that equals or exceeds two-thirds of the
Thrifty Food Plan for the individual and anyone in the individual’s filing
group, if two or fewer meals per day are provided.

(b) A lodger may participate in the SNAP program
independently of the household group when the lodger pays less than a
reasonable amount for room and board.

(8) A household group member is not included in the
filing group, if the member is:

(a) A resident of a commercial boarding house; or

(b) An ineligible student, as defined in OAR
461-135-0570.

(9) A household group member may be included in two
filing groups in the same month, if the member:

(a) Is a resident of a domestic violence shelter (see
OAR 461-001-0000) or safe home (see OAR 461-001-0000); and

(A) When there is a parent (see OAR 461-001-0000) in
the household group (see OAR 461-110-0210), one parent.

(B) When there is no parent in the household group, the
primary person (see OAR 461-001-0000).

(c) In the ERDC program, a caretaker (see OAR
461-001-0000).

(2) In the EA program:

(a) A caretaker relative must sign the application and
complete the application process for a child (see OAR 461-001-0000). If the
child is not living with a caretaker relative, another adult may act on behalf
of the child.

(b) If the caretaker relative lives with a spouse (see
OAR 461-001-0000), both must sign the application.

(c) A dependent child 18 years of age who applies must
sign the application and complete the application process.

(3) In the GA, GAM, OSIPM, and QMB programs, at least
one adult requesting assistance must complete the application process and sign
the application, if able. If there is no adult who is able to sign the
application and complete the application process, this can be done by the
authorized representative (see OAR 461-115-0090). If the applicant dies prior
to the determination of eligibility for OSIPM, the application may be processed
if the Department receives the required verification.

(4) In the SNAP program, the primary person, the spouse
of the primary person, or another adult member of the filing group (see OAR
461-110-0370) must sign the application and complete the application process.

(5) An individual required to sign the application but
unable to sign may sign with a mark, witnessed by an employee of the field
office.

(1) In the SNAP program, none of the following may
serve as authorized representative or alternate payee:

(a) A person disqualified for fraud (unless he or she
is the only adult member of the case).

(b) A landlord or a vendor of goods or items who deals
directly with the client, including a retailer authorized to accept SNAP
benefits.

(c) Unless authorized by the Department’s SNAP Program
Manager or designee, an employee of the Department or an employee of a
contractor involved in the certification and issuance processes for SNAP
benefits.

(d) A provider of meals for the homeless.

(2) An authorized representative or alternate payee who
knowingly misrepresents the circumstances of the filing group (see OAR
461-110-0370) or misuses SNAP benefits is subject to penalty as follows:

(a) In group living (see OAR 461-001-0015) situations
or treatment programs for drug addiction or alcohol abuse, the facility may be
prosecuted under applicable federal or state law.

(b) For other authorized representatives and alternate
payees not covered by subsection (a) of this section, the Department may
prohibit the person from serving as a representative or payee for one year.

(3) Except as provided by this rule or by OAR
461-115-0090, a client may select his or her authorized representative or
alternate payee.

In the SNAP program, a filing group (see OAR
461-110-0370) that is certified for 24 months (see OAR 461-115-0450) must
provide the Department with updated information about their income, shelter and
utility costs, and medical deductions between the first and 15th day of month
12 of their certification period (see OAR 461-001-0000) in order to continue
receiving benefits. The Department follows the process outlined in OAR
461-180-0006 to adjust benefits based on this information.

Stat. Auth.: ORS 411.816

Stats. Implemented: ORS 411.816,
411.825

Hist.: SSP 25-2011, f. 9-30-11,
cert. ef. 10-1-11

461-115-0450

Periodic Redeterminations; SNAP

In the SNAP program, the Department selects the
certification period (see OAR 461-001-0000) and the redetermination date based
on the client’s circumstances and according to the following considerations:

(1) The length of the certification period depends on
how far in advance the circumstances affecting the group’s eligibility can be
predicted but may not exceed 12 months except as outlined in sections (2) and
(4) of this rule.

(2) The certification period may be extended beyond 12
months in each of the following situations:

(a) To the end of the TBA period if the client becomes
eligible for transitional benefits (see OAR 461-135-0506). If eligibility for
TBA ends early, the certification period is changed to end on the last day of
the month.

(b) To include the month after the client finishes
working under a TANF JOBS Plus Agreement. If the agreement ends early, the
certification period is changed to end on the original recertification date or
on the last day of the month following the month in which the JOBS Plus
agreement ends, whichever is later.

(3) A certification period of less than 12 months may
be extended before the certification period ends, not to exceed 12 months, in
each of the following situations:

(a) A one- or two-month certification period for
expedited services when pending information is received, and eligibility and
benefit level is determined based on the new information.

(b) An application or a change report form is received
and eligibility is reviewed.

(c) The report system changes to SRS.

(4) A certification period of 24 months may be used for
households in which all adult members are elderly or have a disability (see OAR
461-001-0015). The household must also not include any earned income to qualify
under this section.

(5) For each benefit group (see OAR 461-110-0750) in
which all members are included in a cash or medical program, eligibility for
SNAP and the other program benefits is determined at the same time when
practicable.

(6) A client remains eligible for and continues to
receive SNAP benefits on the normal issuance cycle if the application for
recertification is filed with the Department and all required verification has
been received by the Department:

(a) Not later than the 15th day of the month in which
the certification expires; or

(b) In the case of a benefit group whose certification
period is shorter than two months, not later than the 15th day after the Department
provides notice that the certification period will expire.

(7) A client who files an application for
recertification is eligible for a SNAP allotment without proration only if the
filing date (see OAR 461-115-0040) is before the prior certification period
expires and:

(a) The required interview is completed, and the
Department receives the required verification, within 30 days after the client
files the application for recertification; or

(b) The interview or verification required by this rule
would have occurred timely but for a delay caused by the Department.

(8) The Department must deny the application for
recertification in the event a client files a timely application for
recertification but either fails to appear for a scheduled interview or fails
to timely submit required verification.

(9) If the client fails to file an application for
recertification during a certification period, SNAP benefits for the first
month of the following certification period are prorated in accordance with OAR
461-180-0080.

(1) If the year of a person’s birth is known but the
month is unknown, the month of birth is presumed to be July. If the date of
birth is unknown, the date of birth is presumed to be the first of the month.

(2) To be eligible for the BCCM program, a woman must
be under 65 years of age.

(3) To be eligible for the CEC program, an individual
must be under 20 years of age.

(4) To be eligible for the CEM program, an individual
must be under 19 years of age.

(5) To be eligible for the EXT, MAA, MAF, or TANF
programs:

(a) A child (see OAR 461-001-0000) must be:

(A) Under 18 years of age; or

(B) Under 19 years of age and regularly attending
school (see OAR 461-120-0530) full time, as determined by the school.

(b) A caretaker relative (see OAR 461-001-0000) may be
any age.

(6) To be eligible for payment of child care costs for
the ERDC or TANF program, a child must be:

(a) Under 12 years of age for the ERDC program or under
13 years of age for the TANF program; or

(b) Under 18 years of age and:

(A) Physically or mentally incapable of selfcare;

(B) Under court supervision;

(C) Receiving foster care;

(D) Eligible for the special need rate for child care
in OAR 461-155-0150; or

(E) Subject to circumstances that significantly
compromise the child’s safety or the caretaker’s ability to work or participate
in an assigned activity if child care is not available.

(7) To be eligible for the OSIP-AB, OSIPM-AB, QMB-BAS,
QMB-SMB, REFM, or SNAP programs, a client may be any age.

(8) To be eligible for the GA and GAM programs, a
client must be:

(a) Eighteen years of age or older and less than 65
years of age; or

(b) Sixty-five years of age or older and must be a
non-citizen who meets the requirements of OAR 461-120-0125.

(9) To be eligible for the OHP program, a client must
meet the age requirements in OAR 461-135-1100.

(10) To be eligible for the OSIP-AD (except OSIP-EPD),
OSIPM-AD (except OSIPM-EPD), and QMB-DW programs, a client must be under 65
years of age.

(11) To be eligible for the OSIP-EPD and OSIPM-EPD
programs, the client must be 18 years of age or older or be legally
emancipated.

(12) To be eligible for the OSIP-OAA or OSIPM-OAA
programs, a client must be 65 years of age or older.

(13) To be eligible for the REF program, a client must
be:

(a) 18 years of age or older;

(b) A legally emancipated minor; or

(c) Part of a TANF filing group that is ineligible for
TANF.

(14) To be eligible for the SAC program, the child must
be under 21 years of age.

(2) A need group (see OAR 461-110-0630) may not be
denied TANF program benefits based on subsections (1)(c) and (d) of this rule
if the PWE is one of the following:

(a) A Parents as Scholars (PAS) participant who
temporarily becomes ineligible for TANF program benefits for four months or
less due to income from a paid work experience (see OAR 461-190-0199);

(b) A teen parent returning to high school or
equivalent;

(c) An individual fleeing from or at risk of domestic
violence (see OAR 461-001-0000);

(d) An individual in the ninth month of pregnancy or
experiencing a medical complication due to the pregnancy which is documented by
a qualified and appropriate professional;

(e) An individual unable to work due to a disability or
medical condition documented by a qualified and appropriate professional, and
which is expected to last for 30 days or more from the date of request (see OAR
461-115-0030) for TANF program benefits;

(f) An individual who is separated from his or her most
recent employment for a reason the Department determines is good cause.

(a) The Department assigns a client to one or more
employment program participation classifications--exempt, mandatory, and
volunteer (see OAR 461-130-0305 for definitions of all three terms).

(b) In the Post-TANF program, a client is classified as
a volunteer.

(2) In the Pre-TANF, REF, and TANF programs:

(a) A client is exempt from employment program
participation and disqualification if the client meets the requirements of at least
one of the following paragraphs. The client is:

(A) Pregnant and in the month before the month in which
the due date of the pregnancy falls.

(B) A parent (see OAR 461-001-0000) during the first
six months after the birth of the parent’s dependent child (see OAR
461-001-0000) except that the Department may require the parent to participate
in parenting classes or a family stability activity (see OAR 461-001-0000). An
exemption allowed under this paragraph may apply only to one mandatory
participant in each filing group.

(C) Under 20 years of age during the first 16 weeks
after giving birth except that the client may be required to participate in
suitable activities with a preference for educational activities, parenting
classes, and family stability activity.

(D) A parent providing care for a family member who is
an individual with a disability (see OAR 461-001-0000) and is in the household
group (see OAR 461-110-0210) with the parent.

(E) An REF client 65 years of age or older.

(F) A TANF client 60 years of age or older.

(G) A noncitizen who is not authorized to work in the
United States.

(H) An individual who is eligible for and receives
supplemental security income (SSI) from the Social Security Administration.

(I) A caretaker relative (see OAR 461-001-0000) who is
non-needy.

(J) A client whose participation is likely to cause
undue hardship or is contrary to the best interests of the dependent child or
needy caretaker relative.

(K) A pregnant client who participates more than 10
hours per week during the two months before the month in which the pregnancy
due date falls.

(L) A VISTA volunteer.

(M) In a one-parent household with a dependent child
(see OAR 461-001-0000) under two years of age, and the client is not a teen
parent (see OAR 461-001-0000).

(b) A parent of a dependent child who receives REF or
TANF program benefits is mandatory if the parent is in the same filing group
(see OAR 461-110-0330) with the dependent child (even if the parent is not in
the REF or TANF program benefit group under OAR 461-110-0750), unless the
parent is otherwise exempt from participation under subsection (a) of this
section.

(3) In the SNAP program:

(a) A client is exempt from employment program
participation and disqualification if the client meets the requirements of one
of the following paragraphs. The client is:

(A) Working a minimum of 30 hours a week or earning
money equal to at least the federal minimum wage multiplied by 30 hours per
week multiplied by 4.3 weeks. A self-employed client with allowable costs must
meet the earnings threshold after allowing the 50 percent deduction. This
includes migrant and seasonal farm workers (see OAR 461-001-0015) who are under
contract or similar agreement with an employer or crew chief to begin employment
within 30 days.

(B) An individual with a physical or mental condition
that prevents performance of any work.

(C) Responsible for the care of a child in the
household under 6 years of age or an individual in the household with a
disability (see OAR 461-001-0015) that substantially reduces or eliminates the
individual’s ability to care for himself or herself.

(D) Providing care for at least 30 hours a week for an
individual in another household with a disability (see OAR 461-001-0015) that
substantially reduces or eliminates the individual’s ability to care for
himself or herself.

(E) Enrolled at least half-time, as defined by the
school, in any high school or equivalent program recognized by a school
district or enrolled at least half-time in any school, training program, or
institution of higher education. Clients remain exempt during normal periods of
class attendance, vacation and recess but no longer qualify for the student
exemption when a break in enrollment occurs due to graduation, suspension or expulsion
or when the student drops out of school or does not enroll in classes for the
next regular school term (excluding summer term).

(F) Receiving REF or TANF program benefits, while a
mandatory participant in the JOBS or NAES programs.

(G) In receipt of unemployment insurance benefits or
has completed an application for unemployment insurance benefits and is waiting
for an initial decision on the claim.

(H) Participating in a drug or alcohol treatment and
rehabilitation program.

(I) Pregnant.

(J) Lacking adequate dependent care.

(K) Without adequate transportation available.

(L) Experiencing a barrier to employment, such as being
homeless or having a short-term physical or mental limitation or a serious
family problem.

(b) A mandatory client is an individual in the need
group (see OAR 461-110-0630); who is 16 or 17 years of age and a primary person
(see OAR 461-001-0015), or 18 years of age and older and 59 years of age and
younger; and who is not exempt under subsection (a) of this section.

(1) To be eligible for MAA, MAF, or TANF program
benefits, a client must be one of the following:

(a) A dependent child (see OAR 461-001-0000). However,
a dependent child for whom foster care payments are made for more than 30 days
is not eligible while the payments are being made for the dependent child.

(b) A caretaker relative (see OAR 461-001-0000) of an
eligible dependent child. However, a caretaker relative to whom foster care
payments are made for more than 30 days is not eligible while the payments are
being made to the caretaker relative.

(c) A caretaker relative of a dependent child, when the
dependent child is ineligible for MAA, MAF, or TANF program benefits because of
one of the following reasons:

(A) The child is receiving SSI.

(B) The child is in foster care, but is expected to
return home within 30 days.

(C) The child is ineligible for MAA or MAF program
benefits because citizenship has not been documented (see OAR 461-115-0705).

(d) An essential person. An essential person is a
member of the household group (see OAR 461-110-0210) who:

(A) Is not required to be in the filing group;

(B) Provides a service necessary to the health or
protection of a member of the benefit group (see OAR 461-110-0750) who has a
mental or physical disability; and

(C) Is less expensive to include in the benefit group
than the cost of purchasing this service from another source.

(e) A parent of an unborn, as follows:

(A) For the TANF and MAA programs, any parent whose
only child is an unborn child once the mother’s pregnancy has reached the
calendar month before the month in which the due date falls.

(B) For the TANF and MAA programs, the father of an
unborn child, if there is another dependent child in the filing group.

(C) For the MAF program, a mother whose only child is
an unborn once the mother’s pregnancy has reached the calendar month
immediately before the month in which the due date falls.

(2) A client is eligible for MAA or MAF program
benefits if the client is:

(a) Eligible for MAA or MAF program benefits under OAR
461-135-0010; or

(A) The minor refuses to live with a parent or legal
guardian as required by OAR 461-135-0080; or

(B) The income of the minor exceeds the income
standards because the Department required the minor to return to live with a
parent, if the minor parent meets the conditions in OAR 461 135 0080(2).

(3) As used in this rule and OAR 461-125-0170:

(a) “Good cause” means a reasonable person of normal
sensitivity, exercising ordinary common sense, would leave work. For an
individual with a physical or mental impairment (as defined at 29 CFR
1630.2(h)), “good cause” for voluntarily leaving work is such that a reasonable
person with the characteristics and qualities of such individual would leave
work.

(b) “Misconduct” means willful or wantonly negligent
violation of the standards of behavior which an employer has the right to
expect of an employee, including an act or series of actions that amount to a
willful or wantonly negligent disregard of an employer’s interest.

(c) “Most recent employment” means the last job held
within the previous 60 days from the date of request (see OAR 461-115-0030) for
TANF program benefits and for which the individual was hired to work 100 or
more hours per month or worked or was scheduled to work 100 or more hours in
the last full calendar month of employment.

(4) Except as provided under section (5) of this rule,
a need group (see OAR 461-110-0630) is not eligible for TANF program benefits
if a caretaker relative in the need group was separated from his or her most
recent employment for any of the following reasons:

(a) Discharged or fired, without good cause for:

(A) Misconduct; or

(B) Felony or theft.

(b) Labor dispute; or

(c) Voluntary quit:

(A) In anticipation of discharge; or

(B) Without good cause.

(5) A need group (see OAR 461-110-0630) may not be
denied TANF program benefits based on section (4) of this rule if the caretaker
relative is one of the following:

(a) A Parents as Scholars (PAS) participant who
temporarily becomes ineligible for TANF program benefits for four months or
less due to income from a paid work experience (see OAR 461-190-0199).

(b) A teen parent returning to high school or
equivalent.

(c) An individual fleeing from or at risk of domestic
violence.

(d) An individual in the ninth month of pregnancy or
experiencing a medical complication due to the pregnancy which is documented by
a qualified and appropriate professional.

(e) An individual unable to work due to a disability or
medical condition documented by a qualified and appropriate professional, and
which is expected to last for 30 days or more from the date of request for TANF
program benefits.

(f) An individual who is separated from his or her most
recent employment for a reason the Department determines is good cause.

(6) If the need group is not eligible for TANF program
benefits solely under section (4) of this rule, the need group is eligible for
MAA or MAF program benefits as long as the need group meets all other
eligibility (see OAR 461-001-0000) requirements.

(7) A client is eligible for MAF program benefits even
while ineligible for TANF program benefits if the client is ineligible for TANF
program benefits only because the client is:

(a) A family who would be eligible for the TANF program
benefits if allowed the following deductions from income:

(A) The earned income deductions authorized by OAR 461
160 0190.

(B) The unearned income support deduction authorized by
OAR 461 160 0200.

(b) A self-employed family who would be eligible for
TANF program benefits if the cost of producing the self employment income was
subtracted from the gross sales or receipts under OAR 461 145 0920.

(c) A family that includes an ineligible non citizen or
the father of an unborn who would be eligible for TANF program benefits if the
ineligible non citizen’s or father’s income is counted under OAR 461-160-0120.

(d) An individual who would be eligible for TANF
program benefits if the assets of the following household members were not
counted:

(A) An unmarried parent of a dependent child or unborn in
the eligibility group.

(B) A child in common of parents in the eligibility
group.

(C) The spouse and each child of a caretaker relative
in the need group.

(e) The spouse of a caretaker relative, but only if the
spouse is the parent of a dependent child.

(8) A family is ineligible for TANF program benefits if
the family meets the requirements of all of the following subsections:

(a) The family lives in Klamath County.

(b) The family meets any of the following conditions:

(A) The family has a single custodial parent who is a
member of the Klamath Tribes, or the single custodial parent is not a Klamath
Tribes member and at least 50 percent of the dependent children are Klamath
Tribes members;

(B) The family has two custodial parents (see OAR
461-001-0000) who are members of the Klamath Tribes, or only one of the two
custodial parents is a Klamath Tribes member and at least 50 percent of the
dependent children are Klamath Tribes members; or

(C) The family has a caretaker relative who is not the
custodial parent and at least 50 percent of the dependent children are Klamath
Tribes members.

(c) The family is eligible for the Klamath Tribes TANF
program or would be eligible for the Klamath Tribes TANF program if not for the
failure of the family to cooperate with program requirements.

(9) A family is ineligible for TANF program benefits if
all of the following subsections apply to the family:

(a) A parent, caretaker relative, or child is a member
of the Siletz Tribe (Confederated Tribes of Siletz Indians of Oregon) and lives
in one of the eleven service area counties: Benton, Clackamas, Lane, Lincoln,
Linn, Marion, Multnomah, Polk, Tillamook, Washington, or Yamhill counties.

(b) The family includes members who are living in the
same household and at least one of the following paragraphs applies:

(A) A two-parent family with one enrolled Siletz tribal
member with a shared dependent.

(B) A single-parent family with one enrolled Siletz
tribal member.

(C) A non-needy caretaker relative or essential person
with one enrolled Siletz tribal member who is a minor.

(D) A pregnant enrolled Siletz tribal member in her
eighth month of pregnancy.

(c) The family is eligible for the Siletz Tribes TANF
program or would be eligible for the Siletz Tribes TANF program if not for the
failure of the family to cooperate with Siletz TANF program requirements.

(10) If a parent or caretaker relative covered by
section (8) or (9) of this rule fails to follow through with a Department
referral to the Klamath or Siletz Tribal TANF program, the entire filing group
is ineligible for TANF program benefits.

(1) For the purposes of this rule and OAR 461-001-0015,
higher education includes the following:

(a) Public and private universities and colleges and
community colleges that offer degree programs regardless of whether a high
school diploma is required for the program. However, GED, ABE, ESL and high
school equivalency programs at those institutions are not considered higher
education.

(b) Vocational, technical, business, and trade schools
that normally require a high school diploma or equivalency certificate for
enrollment in the curriculum or in a particular program at the institution.
However, programs at those institutions that do not require the diploma or
certificate are not considered higher education.

(2) An individual 18 years of age or older, but under
the age of 50 years, who is enrolled at least half time in higher education is
ineligible to receive SNAP program benefits, unless one of the following is
true:

(a) The student is:

(A) A paid employee (see OAR 461-001-0015) working an
average of 20 hours or more per week except as excluded by section (5) of this
rule; or

(B) Self-employed for a minimum of 20 hours per week
and receives weekly earnings at least equal to the federal minimum wage
multiplied by 20 hours.

(b) The student is awarded a state or federally funded
work-study and:

(A) Has been assigned to a work-study position, and
will perform work in a work-study job in the current term or semester. The
period of eligibility for a student eligible because of this paragraph:

(i) Begins with the month in which school begins or
with the month that work study is approved, whichever is later.

(ii) Continues for the duration of the term or
semester, unless the student refuses a work-study job.

(iii) Continues through breaks of less than a month.
For breaks of a month or longer, eligibility continues only if the student
performs work in a work-study job during the break.

(B) The school has no work study positions available.
The period of eligibility for a student eligible because of this paragraph:

(i) Begins with the month in which school begins; and

(ii) Continues for the duration of the term or
semester, unless work study jobs become available and the student refuses a
work-study job.

(c) The student is responsible for the care of a child
in the filing group (see OAR 461-110-0370), and the child is:

(A) Under six years of age; or

(B) Six years of age or older, but under the age of 12
years, and adequate child care is not available to enable the student to both
attend class and meet the employment requirements of sub-section (a) of this
section or the work-study requirements of sub-section (b) of this section.

(d) The student is enrolled full time in higher
education and is a single parent (meaning there is only one parent in the
filing group) or a single adult who has parental control, with the
responsibility of caring for a child under 12 years of age.

(e) The student is in a TANF benefit group (see OAR
461-110-0750).

(f) The student is physically or mentally unfit for
employment.

(g) The student is in job training classes under the
Workforce Investment Act of 1998 (Pub. L. 105-220).

(h) The student is enrolled as a result of
participation in the higher education component of the JOBS program.

(i) The student is enrolled as a result of
employer-sponsored on-the-job training.

(j) The student is receiving Unemployment Compensation
(UC).

(k) The student is participating in at least one of the
following Employment Department training programs:

(3) A student’s enrollment status continues during
school vacation and breaks. A student’s enrollment status ends when the student
graduates, drops out (as verified by the student disenrolling), is suspended or
expelled, or does not intend to register for the next school term (excluding
summer term).

(4) A student residing in a dormitory or other living
situation with meal plans is ineligible for SNAP program benefits.

(5) The following situations do not earn the student
hours toward the 20 hours per week requirement in section (2) of this rule:

(a) Income that is considered educational income under
OAR 461-145-0150, including income from work in the following:

(A) An externship (see OAR 461-001-0015);

(B) A graduate assistantship (see OAR 461-001-0015);

(C) A graduate fellowship (see OAR 461-001-0015); or

(D) An internship (see OAR 461-001-0015).

(b) Receiving in-kind payments in lieu of actual wages.

[Publications: Publications
referenced are available from the agency.]

(1) In the OHP-OPU program, an individual enrolled full
time in higher education is ineligible to receive benefits, unless the
requirements of one of the following subsections are met:

(a) The student:

(A) Meets the income requirements for a Pell grant;

(B) Is not currently covered by private major medical
health insurance (see OAR 461-135-1100) or an HMO; and

(C) Has not been covered by private major medical
health insurance or by an HMO for the six months immediately preceding the date
of application.

(b) The student is in a program serving displaced
workers under Section 236 of the Trade Act of 1974 (19 USC 2296).

(2) For the purposes of this rule:

(a) Higher education includes the following:

(A) Any public or private university, college or
community college.

(B) Any post-secondary vocational or technical school
that is eligible to accept Pell grants.

(b) Full time is defined by the school.

(c) Meets the income requirements for a Pell grant
means:

(A) The student’s Student Aid Report shows an “expected
family contribution” less than $5,274 for the 2010-2011 or 2011-2012 school
year; or

(B) The student is eligible for a Pell grant and
provides documentation of eligibility from the school’s financial aid office.

(3) A student’s enrollment status continues during
school vacation and breaks. A student’s higher education status ends when the
student graduates, drops out (as verified by their disenrolling), reduces the
student’s credit or attendance hours below full-time status, is suspended or
expelled, or does not intend to register for the next school term (excluding
summer term).

For clients who are 18 years of age or older in the GA,
OSIP, and OSIPM programs:

(1) The Department will authorize payment for the cost
of moving a client’s household effects as a one-time special need if the
requirements of at least one of the following subsections are met:

(a) Moving is essential to provide nonhazardous
housing. “Hazardous” housing means a building so deteriorated and unsafe that
it is uninhabitable or subject to condemnation. If no official certification to
that effect can be obtained, the condition of the dwelling must have been seen
by a Department employee and documented in the case record.

(b) The client has been evicted for reasons other than
his or her own neglect or failure to make rent or house payments.

(c) The move is a result of domestic violence or
protective services.

(d) For a client in a nonstandard living arrangement
(see OAR 461-001-0000), the client must move because the level of needed
services increases or decreases.

(e) The needs of the client would be better met out of
state.

(2) Payment for moving costs authorized by this rule:

(a) May be authorized for not more than one move in any
12-month period;

(b) Is limited to the least expensive means possible;
and

(c) Cannot exceed $500 in any 12-month period.

(3) Payments necessary for a one-time move may be made
over a period not to exceed 30 consecutive days.

(4) A filing group that has received a payment for
moving costs under this rule is not eligible for a moving cost payment again
until the first day of the 12th month following the first payment that was made
for the most recent month.

(1) An OSIP or OSIPM program client living in a nursing
facility is not eligible for an accommodation allowance. An OSIP or OSIPM
program client living in a nonstandard living arrangement (see OAR
461-001-0000) is not eligible for an accommodation allowance unless he or she is
receiving, or is eligible to receive after a temporary absence, in-home
waivered services. An OSIP or OSIPM program client receiving SSI or having an
adjusted income less than the OSIPM program income standard (except a client in
a nursing facility) or eligible to receive or receiving in-home waivered
services is allowed an accommodation allowance if the client is 18 years of age
or older and meets the criteria in section (2) or (3) of this rule.

(2) Temporary absence of client from home.

(a) A temporary accommodation allowance may be
authorized, when permitted under section (1) of this rule, if a client meets
the following criteria:

(A) The client leaves his or her home or rental
property and enters an adult foster care facility, assisted living facility, group
care home, hospital, nursing facility, residential care facility, specialized
living facility, or state psychiatric institution;

(B) The client cannot afford to keep the home without
the allowance;

(C) The client will be able to return home within six
months of leaving, according to a written statement from a primary
practitioner, RN, or PAS (pre-admission screening) RN; and

(D) The home will accommodate the service plan of the
client when the client returns.

(b) The allowance may be authorized for six months. If,
after six months, the client continues to meet the criteria in subsection (a)
of this section, an extension may be approved in writing by a supervisor.

(c) The accommodation allowance equals the total of the
client’s housing cost, including taxes and insurance, plus the limited standard
utility allowance for the SNAP program provided in OAR 461-160-0420.

(3) Additional cost for accommodation. A client meeting
the criteria in section (1) of this rule may receive an accommodation allowance
if the client’s shelter cost exceeds the shelter standard in OAR
461-155-0250(2) and the requirements of one of the following subsections are
met:

(a) The client has a documented increase in rent
associated with access by an individual with a disability; or

(b) The client has been assessed to need a live-in
provider, has accepted the services of a live-in provider, and requires an
additional bedroom for the live-in provider.

(4) The accommodation allowance is determined as
follows:

(a) For a client who receives an accommodation
allowance based on increased costs associated with access by an individual with
a disability, only the additional increase in cost for the accommodation is
allowed.

(b) For a client who receives an accommodation
allowance based on the need for an additional bedroom for a live-in provider,
the amount of the accommodation allowance is the limited standard utility
allowance for the SNAP program under OAR 461-160-0420 plus:

(A) One-third of the monthly rental cost; or

(B) One-third of the monthly payment on the property
agreement (including mortgage, trust deed, or land sale contract). The property
agreement is the agreement existing at the time the client is approved for the
accommodation allowance. The accommodation allowance for the housing portion
ends if the debt is refinanced, unless the refinancing was done only to reduce
the original property agreement’s interest rate or total monthly payment amount
and the owner realized no direct or indirect payment of the home’s equity value
from the refinancing.

(i) If the refinancing requirement under this paragraph
is met, the amount of the accommodation allowance is one-third of the
refinanced property agreement amount plus the limited standard utility
allowance under OAR 461-160-0420.

(ii) If the refinancing requirement under this
paragraph is not met and the housing portion of the accommodation allowance
ends, the client remains eligible only for the limited standard utility
allowance portion under OAR 461-160-0420.

(5) Special requirements.

(a) A client who rents and qualifies for an allowance
under section (3) of this rule must take the steps necessary to obtain
subsidized housing under any federal or state housing program. A client who
fails, at any time, to take the steps necessary to obtain subsidized housing
reasonably available is ineligible for the allowance. A client, who has been
denied or revoked from participation in any rent subsidy program based on the
client’s own actions is ineligible for benefits under this rule.

(b) A client who rents housing and refuses subsidized
housing will no longer be eligible for an accommodation allowance, except that
if the housing that is offered is not suitable, related to accommodations, and
the client continues to have increased costs related to accommodations in the
client’s current living situation, the accommodation allowance may continue
until such time as appropriate subsidized housing is found.

(1) The Department provides a telephone allowance for a
client receiving SSI, a client with an adjusted income less than the OSIPM
program standard under OAR 461-155-0250, and a client receiving in-home services
if the client is 18 years of age or older and is unable to leave his or her
residence without assistance due to a documented medical condition.

(2) The telephone allowance may cover the following
costs:

(a) The least expensive appropriate telephone service
or the basic rate, whichever is less.

(b) The cost of telephone adaptive equipment, if the
client has a medically documented need (for instance, TDD, a special headset,
dialing mechanism, or emergency response system).

(c) Necessary installation charges.

(3) An SSI-eligible client or a client with an adjusted
income less than the OSIPM program standard granted a telephone allowance must
apply for a payment through the Oregon Telephone Assistance Program (OTAP). In
addition, an SSI-eligible client or a client with an adjusted income less than
the OSIPM program standard requesting payment for telephone installation must
apply for Link-Up America. If the Link-Up America credit does not cover the
installation cost, the Department provides the difference up to a maximum
supplement payment of $30.

(1) This rule explains how to calculate the client’s
shelter cost. The shelter cost is used to determine the shelter deduction (see
OAR 461-160-0430). The shelter cost is the sum of the client’s cost of housing
plus an allowance for utilities, if the client incurs a utility cost. The
shelter deduction is based on the shelter cost but is subject to a limitation
described in OAR 461-160-0430.

(2) Cost of housing.

(a) The following comprise the cost of housing if they
are incurred with respect to the client’s current residence or the home
described in section (5) of this rule:

(A) Regular, periodic charges for the shelter of the
financial group (see OAR 461-110-0530), such as rent, mortgage payments, and
condominium or association fees. Late fees charged because a mortgage or rent
payment was made late are not deductible.

(B) Property taxes, state and local assessments, and
property insurance on the structure.

(C) Costs for repairing a home substantially damaged or
destroyed by a natural disaster (such as a fire or flood), if such costs are
not reimbursed.

(D) If the need group (see OAR 461-110-0630) is
homeless and living in a vehicle — vehicle payments and collision and
comprehensive insurance premiums for the vehicle.

(b) If housing costs are billed on a weekly or biweekly
basis, the monthly cost is the weekly cost multiplied by 4.3 or the biweekly
cost multiplied by 2.15.

(c) The financial group has the following choices about
housing costs:

(A) The group may choose to apply the cost in the month
it is billed or becomes due.

(B) The group may choose to have periodic costs
averaged.

(C) For expenses that are billed less often than
monthly, the group may choose to have them averaged over the period they are
intended to cover.

(3) Shared housing. If the filing group (see OAR
461-110-0370) shares housing costs with an individual in the dwelling who is
not in the filing group, only the housing costs incurred by the filing group
are included in the calculation. If the portion paid by a person outside the
filing group cannot be ascertained, the cost is apportioned among the people
contributing to the cost. The pro rata share of those not in the filing group is
deducted from the total, and the balance is considered a housing cost of the
filing group.

(4) Cost for utilities.

(a) A filing group has a cost for utilities if it
incurs a cost for heating or cooling; cooking fuel; electricity; water and
sewerage; well installation and maintenance; septic tank system installation
and maintenance; garbage and trash collection; service for a telephone, such as
basic service fee, wire maintenance, subscriber line charges, relay center
surcharges, 911 service, and taxes; or initial installation fees charged by a
utility provider.

(b) If the group incurs no cost for utilities in either
its current home or in the home described in section (5) of this rule, then the
shelter cost is calculated without an allowance for utilities.

(c) If a homeless need group uses a vehicle for
shelter, the cost of fuel for the vehicle is considered a utility cost.

(d) If a filing group incurs a cost for utilities, then
the utility allowance is one of the following:

(A) Allowance with heating or cooling. A full standard
utility allowance of $395 per month is used if the household group (see OAR
461-110-0210) is billed for heating or cooling costs for its dwelling. Charges
for any fuel and for electricity are considered heating costs if they are used
for heating. A financial group who receives an energy assistance payment for
the dwelling provided through the Low Income Energy Assistance Act of 1981 is
eligible for the utility allowance established by this paragraph (A).

(B) Allowance without heating or cooling.

(i) A limited standard utility allowance of $288 per
month is used if the household group is not billed for heating or cooling costs
but is billed for at least two other costs enumerated in subsection (4)(a) of
this rule.

(ii) An individual standard utility allowance of $47
per month is used if the household is not billed for heating or cooling costs
but is billed for only one of the costs enumerated in subsection (4)(a) of this
rule other than the service cost for a telephone, including the related taxes
or fees.

(iii) A telephone standard utility allowance of $53 per
month is used if the household is not billed for heating or cooling costs but
is billed for telephone service, such as basic service fee, wire maintenance,
subscriber line charges, relay center surcharges, 911 service, and taxes.

(5) Housing costs for a home not occupied by the
household. Housing and utility costs with respect to a home not currently
occupied by the household may be considered in calculating the shelter cost if:

(a) The home is temporarily unoccupied because of
employment or training away from home, illness, or abandonment caused by
casualty or natural disaster;

(b) The financial group intends to return to the home;

(c) No other, current occupant is claiming a deduction
for shelter costs in the SNAP program; and

(1) Deductions from income are subtracted from
countable income (see OAR 461-140-0010) in the following order to determine
adjusted income (see OAR 461-001-0000) for the SNAP program:

(a) An earned income deduction of 20 percent of
countable earned income. The 20 percent deduction is not taken from the wages
funded by grant diversions such as Work Supplementation wages.

(b) A standard deduction of $147 per month for a
benefit group (see OAR 461-110-0750) of one, two, or three individuals. A
standard deduction of $155 per month for a benefit group of four individuals. A
standard deduction of $181 per month for a benefit group of five individuals. A
standard deduction of $208 per month for a benefit group of six or more
individuals.

(c) A dependent care deduction for dependent care costs
billed to a member of the financial group (see OAR 461-110-0530) and not paid
for through any other program of the Department. For the cost to be deductible
under this section, the care must be necessary to enable a member of the need
group (see OAR 461-110-0630) to:

(A) Accept or continue employment;

(B) Seek employment, including a job search that meets
the requirements of a case plan (see OAR 461-001-0020); or

(C) Attend vocational or educational training. A
student receiving educational income is entitled to a deduction only for costs
not excluded from educational income by OAR 461-145-0150.

(d) The medical deduction for elderly clients and
clients who have a disability (see OAR 461-001-0015) in the need group. The
deduction is calculated by determining the total of their deductible medical
costs (see OAR 461-160-0415) and subtracting $35. The remainder is the medical
deduction.

(e) A deduction for child support payments (including
cash medical support) a member of the household makes under a legal obligation
to a child not a member of the household group (see OAR 461-110-0210),
including payments for the current month and for payments on arrearages. Child
support is not deductible if collected by setoff through the Oregon Department
of Revenue or by interception of a federal tax refund.

(f) A shelter deduction, calculated as follows:

(A) For SNAP clients required to pay room and board in
a nonstandard living arrangement (see OAR 461-001-0000), the shelter deduction
is:

(i) The cost of room and board, minus the payment
standard for the benefit group; or

(ii) The actual room cost, if the client can prove that
the room cost exceeds the cost described in subparagraph (i) of this paragraph.

(B) For all other clients, the shelter deduction is
calculated as follows:

(i) The standard deduction and the deductions of earned
income, dependent care, court-ordered child support, and medical expenses are
subtracted from countable income. Fifty percent of the remainder is subtracted
from the shelter cost calculated in accordance with OAR 461-160-0420.

(ii) The rounded balance is the deduction, except the
deduction is limited if the filing group has no member who has a disability or
is elderly (see OAR 461-001-0015). The limit is $459 per month.

(2) If the client cannot verify a medical or
court-ordered child-support expense or cannot verify any other expense when
asked to do so, the unverified expense is not used to calculate the deduction.
If the client provides verification, the deduction is applied when calculating
the next month's benefits. If verification is provided within the period
authorized for processing applications (see OAR 461-115-0210), the benefits for
the initial month (see OAR 461-001-0000) are recalculated using the deduction.

(B) A $90 personal needs allowance for a client
receiving long-term care services who is eligible for VA benefits based on
unreimbursed medical expenses. The $90 allowance is allowed only when the VA
benefit has been reduced to $90.

(C) The OSIPM maintenance standard for a client who
receives waivered services.

(d) A community spouse monthly income allowance is
deducted from the income of the institutionalized spouse to the extent that the
income is made available to or for the benefit of the community spouse, using
the following calculation.

(A) Step 1: Determine the maintenance needs allowance.
$1,839 is added to the amount over $552 that is needed to pay monthly shelter
expenses for the principal residence of the couple. This sum or $2,739
whichever is less, is the maintenance needs allowance. For the purpose of this
calculation, shelter expenses are the rent or home mortgage payment (principal
and interest), taxes, insurance, required maintenance charges for a condominium
or cooperative, and the full standard utility allowance for the SNAP program
(see OAR 461-160-0420).

(B) Step 2: Compare maintenance needs allowance with
community spouse’s countable income. The countable income of the community
spouse is subtracted from the maintenance needs allowance determined in step 1.
The difference is the income allowance unless the allowance described in step 3
is greater.

(C) Step 3: If a spousal support order or exceptional
circumstances resulting in significant financial distress require a greater
income allowance than that calculated in step 2, the greater amount is the
allowance.

(e) A dependent income allowance as follows:

(A) For a case with a community spouse, a deduction is
permitted only if the monthly income of the eligible dependent is below $1,839.
To determine the income allowance of each eligible dependent:

(i) The monthly income of the eligible dependent is
deducted from $1,839.

(ii) One-third of the amount remaining after the
subtraction in paragraph (A) of this subsection is the income allowance of the
eligible dependent.

(B) For a case with no community spouse:

(i) The allowance is the TANF adjusted income standard
for the client and eligible dependents.

(ii) The TANF standard is not reduced by the income of
the dependent.

(f) Costs for maintaining a home if the client meets
the criteria in OAR 461-160-0630.

(g) Medical deductions allowed by OAR 461-160-0030 and
461-160-0055 are made for costs not covered under the state plan. This includes
the public and private health insurance premiums of the community spouse and
the client’s dependent.

(h) After taking all the deductions allowed by this
rule, the remaining balance is the adjusted income.

(i) The client liability is determined as follows:

(A) For a client receiving waivered services (except a
client identified in OAR 461-160-0610(4)), the liability is the actual cost of
the waivered service or the adjusted income of the client, whichever is less.
This amount must be paid to the Department each month as a condition of being
eligible for waivered services. In OSIPM-IC, the liability is subtracted from
the gross monthly benefit.

(B) For a client who resides in a nursing facility, a
state psychiatric hospital, an Intermediate Care Facility for the Mentally
Retarded, or a non-waivered mental health facility, there is a liability as
described at OAR 461-160-0610.

(4) The deduction used to determine adjusted income for
a GA and GAM client receiving long-term care services or waivered services is
as follows:

(a) One standard earned income deduction of $65 is made
from the earned income for a client who is not blind; or

(b) One standard earned income deduction of $85 is made
from the earned income for a client who is blind.

(1) Notwithstanding any other provision in Chapter 461
of the Oregon Administrative Rules, effective July 1, 2011, participation in
Parents as Scholars (PAS) is limited to clients approved for PAS as of June 30,
2011. Any other PAS applicant is not eligible for enrollment in PAS, including
a client on the PAS wait list after June 30, 2011. The Department does not
process any application for PAS received after June 30, 2011.

(2) PAS is a JOBS program component that assists TANF
parents who are or will be undergraduates to begin or continue their education
at a two- or four-year educational institution.

(3) The following definitions apply to PAS:

(a) “Educational institution” means any post-secondary
educational institution approved or accredited by the Northwest Commission on
Colleges and Universities, by its regional equivalent, or by the appropriate
official, department, or agency of the state or nation in which the institution
is located and that is:

(A) A four-year college or university;

(B) A junior college or community college; or

(C) A technical, professional or career school.

(b) “Participant” refers to a participant in the PAS
component of the JOBS program.

(c) “PAS” means the Parents as Scholars component of
the JOBS program.

(4) The number of participants in PAS in a calendar
year is limited as follows:

(a) The number of participants in PAS in a calendar
year may not exceed one percent of the number of households receiving TANF on
January 1 of that calendar year.

(b) If one percent of the number of households
receiving TANF on January 1 of the current calendar year is less than one
percent of the number of households receiving TANF on January 1 of the previous
calendar year, the Department will not fill PAS slots vacated on or after
January 1 of the current calendar year until the total number of slots is equal
to one percent of the households receiving TANF for the current calendar year.

(5) A PAS participant receives TANF cash assistance as
well as necessary support services provided through the JOBS program. JOBS
support services:

(a) May not be used to pay for the cost of tuition and
fees associated with enrollment by a participant at an educational institution.

(b) Subject to the limitations of OAR 461-190-0211, may
be used to pay for books and supplies associated with enrollment by a
participant at an educational institution subject to the following provisions:

(A) The books and supplies are required for completion
of the participant’s coursework at an educational institution;

(B) There is no other funding available to the PAS
participant for books and supplies; and

(C) No more than $100 per academic term or semester may
be paid per PAS participant for books and supplies.

(6) Applying for PAS. A parent who is applying for or
receiving TANF may apply for PAS by completing and signing the PAS application
and submitting it to the Department. The application and other documentation
required by this rule must be submitted to Department of Human Services JOBS
Unit (PAS), 2nd Floor, 500 Summer Street NE E48, Salem, Oregon 97301.

(7) PAS Selection Process; Wait List.

(a) PAS applications received from PAS applicants will
be processed in the order in which the Department receives the applications.

(b) If the maximum number of PAS slots for a calendar
year has not been filled, the Department will notify an applicant when he or
she has been approved.

(c) When the maximum number of PAS slots for a calendar
year has been filled and there is a wait list, the Department will notify an
applicant when he or she has been added to the wait list.

(d) Once each year, the Department will contact PAS
applicants on the wait list to determine if the PAS applicant’s name should be
removed from the wait list.

(e) When the maximum number of PAS slots for a calendar
year has been filled and there is a wait list and a PAS slot becomes available,
the Department will notify the next applicant on the wait list that an opening
has become available.

(f) The Department will inform an applicant for PAS who
does not qualify or no longer qualifies for placement on the wait list because
the applicant becomes ineligible for TANF or no longer meets the requirements
of this rule.

(8) Selection Requirements.

(a) A PAS applicant must meet the financial and
nonfinancial eligibility requirements for TANF.

(b) A PAS applicant who is not applying for or
receiving TANF at the time of selection may not participate in PAS or remain on
the wait list.

(c) A PAS applicant must include documentation that the
PAS applicant is an undergraduate who has been accepted for full-time
attendance into or is enrolled full-time at an educational institution.

(d) A PAS applicant must demonstrate as part of the PAS
application that completion of the educational program is likely to result in
employment that provides the wages and benefits necessary for the applicant to
support the applicant’s family without TANF.

(9) Requirements of Participants; Limitations.

(a) A participant must provide documentation to the
Department quarterly, or following completion of each academic term at the
educational institution, that the participant is making satisfactory academic
progress, as defined by the educational institution, toward a degree.

(b) A participant must provide documentation to the
Department, prior to the start of each new academic term or semester, that the
PAS applicant is an undergraduate who is enrolled full-time at an educational
institution.

(c) A participant must attend classes full-time as
defined by the educational institution, unless there is good cause (see OAR
461-130-0327) to limit attendance to less than full-time.

(d) Unless there is good cause for not attending year
round, a participant must either:

(A) Attend classes year round, including during the
summer if classes are offered by the educational institution; or

(B) If not attending classes year round, participate in
work experience related to the field of study of the participant when not
attending classes. If a work experience related to the participant’s field of
study is not available, participate in another appropriate work experience.

(e) During the first twelve months of participation in
PAS, a participant must record attendance and homework time weekly and must
provide this information to the Department no less frequently than monthly.

(f) Except as provided in subsection (g) of this
section, a participant must remain eligible for TANF.

(g) If a participant becomes temporarily ineligible for
TANF during a period of four or fewer months due to income from a paid work
experience, the applicant may retain their PAS slot when school resumes if:

(A) The participant regains TANF eligibility; and

(B) PAS is still an appropriate activity for the
participant.

(10) Ending PAS. PAS is ended for a PAS participant
when:

(a) The PAS participant completes his or her degree
program;

(b) Except as provided in subsection (9)(g) of this
rule, the PAS participant becomes ineligible for TANF; or

(c) All of the following are true:

(A) The PAS participant fails to meet one or more of
the requirements of subsections (9)(a) through (9)(e) of this rule;

(B) Attempts to re-engage the PAS participant pursuant
to OAR 461-190-0231 are unsuccessful; and

(C) There is a determination that the PAS participant
does not have good cause (see OAR 461-130-0327) for failure to meet one or more
requirements of subsections (9)(a) through (9)(e) of this rule.

Notwithstanding any other administrative rule in
Chapter 461 and subject to the limitations of state funding, the following
special provisions apply:

(1) As provided in all of the following subsections,
participation in a case plan (see OAR 461-001-0025) activity (see OAR
461-001-0025) is limited to:

(a) An individual who is determined to be a
work-eligible individual according to federal definition (45 CFR 261.2(n)(1)).
No individual may volunteer to participate in an activity of a case plan if not
otherwise determined to be a work-eligible individual.

(b) An individual who is an applicant in the TANF
Eligibility Determination Period (TANF-EDP) or a recipient of TANF program
benefits.

(2) For eligible individuals, subject to the
requirements and limitations in sections (1), (5), (6), and (7) of this rule,
the following activities will be available and include support services (see
OAR 461-001-0025) payments:

(a) Job search (see OAR 461-001-0025).

(b) JOBS Plus (see OAR 461-001-0025 and 461-101-0010)
is limited to six months per individual.

(c) Work experience (see OAR 461-001-0025), alone or in
combination with any other unpaid volunteer work, is limited to 60 days per
individual.

(d) Sheltered or supported work (see OAR 461-001-0025),
alone or in combination with any other unpaid volunteer work, is limited to 60
days per individual.

(e) High School or GED (see OAR 461-001-0025) limited
to a teen parent (see OAR 461-001-0025).

(f) Parents as Scholars (see OAR 461-001-0025).

(3) The following activities will be available but will
not include support services payments:

(a) Domestic Violence Intervention.

(b) Family Stability (see OAR 461-001-0000).

(c) Family Support & Connection.

(d) Post-TANF.

(e) Program entry (see OAR 461-001-0025).

(f) Self Initiated Training (see OAR 461-001-0025).

(g) SSI Application Process.

(h) Unsubsidized employment (work).

(4) Participation in an activity is based on whether an
individual is Job Ready, Near Job Ready, or Not Job Ready.

(a) Job Ready means the individual has no barrier (see
OAR 461-001-0025) or current barriers do not impact participation or
employment. In addition, the individual has all of the following:

(A) Prior stable work history, either paid or unpaid.

(B) Had not voluntarily quit or been dismissed from
their most recent employment (see OAR 461-135-0070), without good cause (see
OAR 461-135-0070).

(C) Reliable or available transportation.

(D) No outstanding legal issues that would impact or
prevent employment.

(E) Access to reliable child care within support
service limits, or does not need help to pay for child care, or does not need
child care.

(b) Near Job Ready means the individual has minimal
barriers to participation or employment and the individual is addressing the
barriers. In addition, the individual has all of the following:

(A) Limited or no work history, either paid or unpaid.

(B) Reliable or available transportation.

(C) No outstanding legal issues that would impact or
prevent employment, or such legal issues are identified and are being
addressed.

(D) Access to reliable child care within support
service limits, or does not need help to pay for child care, or does not need
child care.

(c) Not Job Ready means the individual has one or more
barriers to participation or employment or is in crisis, and the individual is
not addressing the barriers. For example, the individual has one or more of the
following:

(A) Lack of stable housing that is preventing
participation in an activity or employment.

(B) Domestic violence, mental health or alcohol and
drug issues, and the individual is not addressing the issue.

(C) Medical issues that prevent participation in an
activity or employment.

(D) Outstanding legal issues that would impact or
prevent employment.

(E) Literacy issues that impact the ability for the
individual to participate in an activity or obtain employment.

(5) In approving JOBS program support service payments,
the Department must consider lower cost alternatives. It is not the intent of
the Department or of this rule to supplant Department funding with other
funding that is available in the community. It is the Department’s expectation
that case managers and clients will work collaboratively to seek resources that
are reasonably available to the client in order to participate in activities.

(6) Payments for support services are only provided
when:

(a) Necessary to participate in activities in a signed
case plan;

(b) Authorized in advance; and

(c) All other provisions of this rule are met.

(7) Payments for support services are subject to the
following limitations:

(a) Job Ready individuals may be eligible for child
care, transportation, or other support services.

(b) Near Job Ready individuals may be eligible for
child care, transportation, or other support services.

(c) Not Job Ready individuals are not eligible for
support services.

(d) A teen parent (see OAR 461-001-0000) may be
eligible for child care, transportation, or other support services, for
participation in a basic education (see OAR 461-001-0025) component (see OAR
461-001-0025).

(e) $450 maximum per filing group, per month, for a
filing group who resides in the District 2, 4, 5, 9, 10, 15 or 16 service area.

(f) $375 maximum per filing group, per month, for a
filing group who resides in the District 1, 3, 6, 7 or 8 service area.

(g) $300 maximum per filing group, per month, for a
filing group who resides in the District 11, 12, 13 or 14 service area.

(h) Child Care. Payments for child care may be
authorized, as limited by OAR 461-160-0040, if necessary to enable a
single-parent Job Ready or Near Job Ready individual or single teen parent to
participate in an approved JOBS program activity specified in the individual’s
case plan. If authorized, payment for child care will be made for the lesser
of:

(A) The maximum monthly support service amount based on
District service area under this section of the rule.

(B) The lesser of the actual rate charged by the care
provider and the rate established in OAR 461-155-0150. The Department rate for
children in care less than 158 hours in a month is limited by OAR 461-155-0150,
except that the cost of child care may be paid up to the monthly maximum when
children are in care less than 158 hours per month and the individual is a teen
parent using on-site care while attending education activities.

(C) The minimum hours necessary, including meal and
commute time, for the individual to participate in an approved JOBS program
activity.

(i) Transportation. The Department may provide payments
for a Job Ready or Near Job Ready individual or teen parent for transportation
costs incurred in travel to and from an approved JOBS program activity. Payment
is made only for the cost of public transportation or the cost of fuel.
Payments are subject to the following considerations:

(A) Payment for transportation may not exceed $50 per
month, per family.

(B) Payment for public transportation is a priority
over payment for a privately owned vehicle.

(C) Payment for fuel costs for a privately-owned
vehicle is provided if the Job Ready or Near Job Ready individual, teen parent,
or the individual providing the transportation has a valid driver’s license and
vehicle insurance and either of the following is true:

(i) No public transportation is available or the Job
Ready or Near Job Ready individual or teen parent is unable to use public
transportation because of a verifiable medical condition or disability for
which no accommodation is available.

(ii) Public transportation is available but is more
costly than the cost of fuel.

(j) Housing and Utilities. Payments for housing and
utilities are not allowed.

(k) Other Payments. The Department may provide payments
to individuals for costs directly related to obtaining unsubsidized employment.

(8) The Department may require an individual to provide
verification of a need for, or costs associated with, support services prior to
approval and issuance of payment if verification is reasonably available.

(9) The Department may reduce, close, or deny in whole
or in part an individual’s request for a support services payment in the
following circumstances:

(a) The individual is disqualified for failing to
comply with a case plan, unless the payment in question is necessary for the
individual to demonstrate cooperation with his or her case plan.

(b) The purpose for the payment is not related to the
individual’s case plan.

(c) The individual disagrees with a support services
payment offered or made by the Department as outlined in the individual’s case
plan.

(d) The individual is not determined to be a Job Ready
or Near Job Ready individual or teen parent.

Notwithstanding any other administrative rule in
Chapter 461 in effect on June 30, 2011, except as provided in section (4) of
this rule, effective at the end of the day on June 30, 2011, in the JOBS,
Post-TANF, Pre-TANF, REF, SFPSS, TA-DVS, and TANF programs:

(3) Transition Services (see OAR 461-190-0241).
Eligibility for, and payments made on behalf of, an individual who is
ineligible for the Pre-TANF or TANF programs because of an increase in earned
income, ends.

(4) This rule does not apply to an individual in the
JOBS Plus program (JOBS Plus) (see OAR 461-001-0025 and 461-101-0010) or the Parents
as Scholars (PAS) (see OAR 461-001-0025) activity.

This rule applies to benefits and services delivered
under chapters 410, 411, and 461 of the Oregon Administrative Rules.

(1) “Overpayment” means:

(a) A benefit or service received by or on behalf of a
client, or a payment made by the Department on behalf of a client, that exceeds
the amount for which the client is eligible.

(b) A payment made by the Department and designated for
a specific purpose which is spent by a person on an expense not approved by the
Department.

(c) A payment for child care made by the Department to,
or on behalf of, a client that:

(A) Is paid to an ineligible provider;

(B) Exceeds the amount for which a provider is
eligible;

(C) Is paid when the client was not engaged in an
activity that made the client eligible for child care, such as an activity of
the JOBS program (see OAR 461-001-0025 and 461-190-0151 to 461-190-0401);

(D) Is paid when the client was not eligible for child
care benefits; or

(E) Has given an electronic benefit transfer (EBT)
card, card number, or personal identification number (PIN) to a provider for
the purpose of checking a child in or out from the provider’s child care.

(d) A misappropriated payment when a person cashes and
retains the proceeds of a check from the Department on which that person is not
the payee and the check has not been lawfully endorsed or assigned to the person.

(e) A benefit or service provided for a need when that
person is compensated by another source for the same need and the person fails
to reimburse the Department when required to do so by law.

(f) A cash benefit received by an individual in the GA
or SFPSS programs for each month for which the client receives a retroactive
SSI lump sum payment.

(g) In the TA-DVS program, only when an IPV in the
TA-DVS program is established.

(2) The Department may establish an overpayment for the
initial month (see OAR 461-001-0000) of eligibility under circumstances
including but not limited to:

(c) The Department fails to use income reported as
received or anticipated in determining the benefits of the filing group; or

(d) The error was due to an error in computation or
processing by the Department.

(3) Overpayments are categorized as follows:

(a) An administrative error overpayment is an
overpayment caused by any of the following circumstances:

(A) The Department fails to reduce, suspend, or end
benefits after timely reporting by the filing group, ineligible student, or
authorized representative of a change covered under OAR 461-170-0011 and that
reported change requires the Department to reduce, suspend, or end benefits;

(B) The Department fails to use the correct benefit
standard;

(C) The Department fails to compute or process a
payment correctly based on accurate information timely provided by the filing
group, ineligible student, or authorized representative;

(D) In the GA and SFPSS programs, the Department fails
to require a client to complete an interim assistance agreement; or

(E) The Department commits a procedural error that was
no fault of the filing group, ineligible student, or authorized representative.

(b) A client error overpayment is any of the following:

(A) An overpayment caused by the failure of a filing
group, ineligible student, or authorized representative to declare or report
information or a change in circumstances as required under OAR 461-170-0011,
including information available to the Department, that affects the client’s
eligibility to receive benefits or the amount of benefits.

(B) A client’s unreduced liability or receipt of
unreduced benefits pending a contested case hearing decision or other final
order favorable to the Department.

(C) A client’s failure to return a benefit known by the
client to exceed the correct amount.

(D) A client’s use of a JOBS or SFPSS program support
payment (see OAR 461-190-0211) for other than the intended purpose.

(E) A payment for child care when the client was not
engaged in an activity that made the client eligible for child care, such as an
activity of the JOBS program (see OAR 461-001-0025 and 461-190-0151 to
461-190-0401).

(F) A payment for child care when the client was not
eligible for child care benefits.

(G) The failure of a client to pay his or her entire
share of the cost of services or the participant fee (see OAR 461-160-0610 and
461-160-0800) in the month in which it is due.

(H) An overpayment caused by a client giving an electronic
benefit transfer (EBT) card, card number, or personal identification number
(PIN) to a provider for the purpose of checking a child in or out from the
provider’s child care.

(c) A fraud overpayment is an overpayment determined to
be an intentional program violation (see OAR 461-195-0601 and 461-195-0611) or
substantiated through a criminal prosecution.

(d) In the SNAP program, a provider error overpayment
is an overpayment made to a drug or alcohol treatment center or residential
care facility that acted as a client’s authorized representative.

(e) In the child care program, a provider error
overpayment is a payment made by the Department on behalf of a client to a
child care provider when:

(A) Paid to an ineligible provider;

(B) The payment exceeds the amount for which a provider
is eligible.

(4) When an overpayment is caused by both an
administrative and client error in the same month, the Department determines
the primary cause of the overpayment and assigns as either an administrative or
client error overpayment.

(5) In the SNAP program, the trading of a controlled
substance (as defined in section 102 of the Controlled Substances Act in 21
U.S.C. 802) is the buying or selling of SNAP program benefits for cash or
consideration other than eligible food; or the exchange for SNAP program
benefits of firearms, ammunition, explosives, or controlled substances.

(6) In the TANF program, when an overpayment puts the
client at greater risk of domestic violence (see OAR 461-001-0000), the
overpayment is waived (see OAR 461-135-1200).

This rule specifies how the Department calculates an
overpayment (see OAR 461-195-0501).

(1) The Department calculates an overpayment by
determining the amount the client received or the payment made by the
Department on behalf of the client that exceeds the amount for which the client
was eligible.

(2) When a filing group, ineligible student, or
authorized representative (see OAR 461-115-0090) fails to report income, the
Department calculates and determines the overpayment by assigning unreported
income to the applicable budget month without averaging the unreported income,
except a client’s earned income reported quarterly from the Employment
Department is considered received by the client in equal amounts during the
months identified in the report.

(3) When using prospective budgeting (see OAR 461-150)
and the actual income differs from the amount determined under OAR
461-150-0020(2), there may be a client error overpayment (see OAR 461-195-0501)
only when the filing group, ineligible student, or authorized representative
withheld information, failed to report a change, or provided inaccurate
information. In such a case, the Department uses the actual income to determine
the amount of an overpayment.

(4) When a filing group, ineligible student, or
authorized representative fails to report all earned income within the
reporting time frame, the earned income deduction (see OAR 461-145-0930,
461-160-0160, 461-160-0190, 461-160-0430, 461-160-0550, and 461-160-0552) is
applied as follows:

(a) In the ERDC, OSIP, OSIPM, QMB, and REFM programs,
the Department allows the earned income deduction.

(b) In the MAA, MAF, REF, and TANF programs, the
Department allows the earned income deduction when good cause (see section (5)
of this rule) exists.

(c) In the SNAP program, no deduction is applied to
earned income not timely reported.

(5) For the purposes of OAR 461-195-0501 to
461-195-0561, “good cause” means circumstances beyond the client’s reasonable
control that caused the client to be unable to report income timely and
accurately.

(6) When support is retained:

(a) In the TANF program, the amount of support (other
than cash medical support) the Department of Justice retains as a current
reimbursement each month is added to other income to determine eligibility.
When a client is not eligible for TANF program benefits, the overpayment is
offset by the support the Department of Justice retains as a current
reimbursement.

(b) In the medical programs, the amount of the cash
medical support the Department retains each month is excluded income and not
used to determine eligibility for medical program benefits. When a client has
incurred a medical program overpayment, the overpayment is offset by the amount
of the cash medical support the Department retains during each month of the
overpayment.

(7) In the REF and TANF programs, when a client
directly receives support used to determine eligibility or calculate benefits,
the overpayment is:

(a) If still eligible for REF or TANF program benefits,
the amount of support the client received directly; or

(b) If no longer eligible for REF or TANF program
benefits, the amount of program benefits the client received.

(8) When an overpayment occurs due to the failure of an
individual to reimburse the Department, when required by law to do so, for
benefits or services (including cash medical support) provided for a need for
which that individual is compensated by another source, the overpayment is
limited to the lesser of the following:

(a) The amount of the payment from the Department;

(b) Cash medical support; or

(c) The amount by which the total of all payments
exceeds the amount payable for such a need under the Department’s rules.

(9) Benefits paid during a required notice period (see
OAR 461-175-0050) are included in the calculation of the overpayment when:

(a) The filing group, ineligible student, or authorized
representative failed to report a change within the reporting time frame under
OAR 461-170-0011; and

(b) Sufficient time existed for the Department to
adjust the benefits to prevent the overpayment if the filing group, ineligible
student, or authorized representative had reported the change at any time
within the reporting time frame.

(10) In the SNAP program:

(a) If the benefit group (see OAR 461-110-0750) was
categorically eligible, there is no overpayment based on resources.

(b) For a filing group (see OAR 461-110-0370) found
eligible for SNAP program benefits under OAR 461-135-0505(1)(a) to (c), and the
actual income made the group ineligible for the related program, the group
remains categorically eligible for SNAP program benefits as long as the
eligibility requirement under OAR 413-135-0505(1)(d) is met. A benefit group of
one or two individuals would be entitled to at least the minimum SNAP program
benefit allotment under OAR 461-165-0060.

(c) For a filing group found eligible for SNAP program
benefits only under OAR 461-135-0505(1)(d), and the actual income equals or
exceeds 185 percent of the Federal Poverty Level, the filing group is no longer
categorically eligible. The overpayment is the amount of SNAP program benefits
incorrectly received.

(11) In the OSIP and OSIPM programs, when a client does
not pay his or her share of the cost of services (see OAR 461-160-0610) or the
OSIP-EPD or OSIPM-EPD program participant fee (see OAR 461-160-0800) in the
month in which it is due, an overpayment is calculated as follows:

(a) All payments made by the Department on behalf of
the client during the month in question are totaled, including but not limited
to any payment for:

(A) Capitation;

(B) Long term care services;

(C) Medical expenses for the month in question;

(D) Medicare buy-in (when not concurrently eligible for
an MSP);

(E) Medicare Part D;

(F) Mileage reimbursement;

(G) Special needs under OAR 461-155-0500 to
416-155-0710; and

(H) Waivered services, including home delivered meals
and non-medical transportation.

(b) Any partial or late liability payment made by a
client receiving in-home waivered services (see OAR 461-001-0030) or
participant fee paid by an OSIP-EPD or OSIPM-EPD program client is subtracted
from the total calculated under subsection (a) of this section. The remainder,
if any, is the amount of the overpayment.

(12) When a client’s liability is unreduced pending the
outcome of a contested case hearing about that liability the overpayment is the
difference between the liability amount determined in the final order and the
amount, if any, the client has repaid.

(13) In the BCCM, CEC, CEM, EXT, MAA, MAF, OHP-CHP,
OHP-OPC, OHP-OPP, OHP-OPU, OHP-OP6, OSIPM, QMB, REFM, and SAC programs if the
client was not eligible for one program, but during the period in question was
eligible for another program:

(a) With the same benefit level, there is no
overpayment.

(b) With a lesser benefit level, the overpayment is the
amount of medical program benefit payments made on behalf of the client
exceeding the amount for which the client was eligible.

(14) When an overpayment is caused by administrative
error (see OAR 461-195-0501), any overpayment of GA, OSIP, REF, SFPSS, or TANF
program benefits is not counted as income when determining eligibility for the
EXT, GAM, MAA, MAF, OSIPM, REFM, and SAC programs.

(15) Credit against an overpayment is allowed as
follows:

(a) In the GA, REF, and TANF programs, a credit is
allowed for a client’s payment for medical services made during the period
covered by the overpayment, in an amount not to exceed the Department fee
schedule for the service, but credit is not allowed for an elective procedure
unless the Department authorized the procedure prior to its completion.

(b) In the SNAP program, if the overpayment was caused
by unreported earned income, verified child care costs are allowed as a credit
to the extent the costs would have been deductible under OAR 461-160-0040 and
461-160-0430.

(c) In the SFPSS and TANF programs, if the overpayment
is caused by reported earned income, a credit is allowed for the Post-TANF
grant if the client meets eligibility under OAR 461-135-1250 and the client has
received less than 12 months of Post-TANF program benefits.

(d) In all programs, for an underpayment of benefits.

(16) In the SNAP program, in compliance with the
American Recovery and Reinvestment Act of 2009, effective April 1, 2009 through
September 30, 2009, the amount between the normal Thrifty Food Plan (TFP)
benefit amount under this section and the increased TFP benefit amount under
OAR 461-155-0190 is not counted in the overpayment amount unless the filing
group was ineligible for SNAP program benefits. [Table not included. See ED.
NOTE]

(a) Each individual in the filing group or required to
be in the filing group and the payee when the overpayment was incurred, except
an individual who did not reside with and did not know he or she was included
in the filing group.

(b) A caretaker relative (see OAR 461-001-0000) and his
or her spouse (see OAR 461-001-0000) who were not part of, but resided with,
the filing group when the overpayment was incurred.

(c) A parent (see OAR 461-001-0000) or caretaker
relative of a child (see OAR 461-001-0000) in the benefit group (see OAR
461-110-0750) and the spouse of the parent or caretaker relative if the parent,
caretaker relative, or spouse was a member of or resided with the filing group
when the overpayment was incurred.

(d) An individual determined liable for an overpayment
remains liable when the individual becomes a member of a new filing group.

(e) An authorized representative (see OAR 461-115-0090)
when the authorized representative gave incorrect or incomplete information or
withheld information resulting in the overpayment.

(2) In the BCCM, CEC, CEM, EXT, MAA, MAF, OHP, REFM,
and SAC programs, the following persons are liable for repayment of an
overpayment:

(a) Each individual in the filing group or required to
be in the filing group and the payee when the overpayment was incurred, except
an individual who:

(A) Was a child or dependent child (see OAR
461-001-0000) at the time of the overpayment; or

(B) Did not reside with and did not know he or she was
included in the filing group.

(b) A caretaker relative and his or her spouse who were
not part of, but resided with, the filing group when the overpayment was
incurred.

(c) A parent or caretaker relative of a child in the
filing group and the spouse of the parent or caretaker relative if the parent,
caretaker relative, or spouse was a member of or resided with the filing group
when the overpayment was incurred.

(d) An authorized representative when the authorized
representative gave incorrect or incomplete information or withheld information
that resulted in the overpayment.

(3) In a child care program:

(a) An overpayment caused by administrative error is
collectible as follows:

(A) The provider is liable for a provider overpayment
made on behalf of a client eligible for child care payments.

(B) Each adult in the filing group or required to be in
the filing group is liable for an overpayment if the client was not eligible
for the payment.

(b) Each adult in the filing group or required to be in
the filing group is liable for a client overpayment, and a provider is liable
for an overpayment caused by the provider. The client and provider are jointly
and severally liable for an overpayment caused by both. In the case of an
alleged provider overpayment, a provider’s failure to provide contemporaneous
records of care provided creates a rebuttable presumption that the care was not
provided.

(c) An adult who cosigned an application with a minor
provider applicant is liable for an overpayment incurred by the minor provider.

(4) In the GA, GAM, OSIP, OSIPM, and QMB programs, the
following persons are liable for repayment of an overpayment:

(a) Each individual in the filing group or required to
be in the filing group and the payee when the overpayment was incurred, except
an individual who:

(A) Was a child or dependent child at the time of the
overpayment; or

(B) Did not reside with and did not know he or she was
included in the filing group.

(b) A caretaker relative and his or her spouse who were
not part of, but resided with, the filing group when the overpayment was
incurred.

(c) A parent or caretaker relative of a child in the
filing group and the spouse of the parent or caretaker relative if the parent,
caretaker relative, or spouse was a member of or resided with the filing group
when the overpayment was incurred.

(d) An authorized representative when the authorized
representative knowingly gave incorrect or incomplete information or
intentionally withheld information that resulted in the overpayment.

(5) In the SNAP program, the following persons are
liable for repayment of an overpayment or a claim that results from the trading
of a controlled substance (see OAR 461-195-0501(6)):

(a) The primary person (see OAR 461-001-0015) of any
age, an ineligible student in the household, and all adults who were members of
or required to be in the filing group (see OAR 461-110-0370) when excess
benefits were issued.

(b) A sponsor of a non-citizen household member if the
sponsor is at fault, for payments prior to November 21, 2000.

(c) A drug or alcohol treatment center or residential
care facility that acted as the authorized representative of the client.

(6) Except as provided otherwise in section (7) of this
rule, in all programs, both a non-citizen and the sponsor of the non-citizen
are liable for an overpayment incurred if the overpayment results from the
failure of the sponsor to provide correct information (see OAR 461-145-0820 to
461-145-0840). If the sponsor had good cause (see OAR 461-195-0521(5)) for
withholding the information, the sponsor is not liable for the overpayment.

(7) In the SNAP program, the sponsor of a non-citizen
is not liable under section (6) of this rule for payments on or after November
21, 2000.

Intentional Program Violations;
Penalties and Liability for Overpayments

(1) Disqualification penalties resulting from
intentional program violations and other violations of law are listed in this
rule. A person may be subject to disqualification for an IPV only if the person
was advised of the disqualification penalties prior to committing the IPV. A
disqualification established in another state continues in effect in Oregon.

(2) In the ERDC program, if an IPV is established
against a person through a contested case hearing, a waiver of the right to
hearing, or by a state or federal court, that person is liable for repayment to
the Department of the full amount of overpayment the Department has
established. The amount of restitution to the Department ordered by a court as
part of a criminal proceeding does not lower the amount owed to the Department.
Payments of restitution to the Department are credited against the amount owed.
A client is not subject to an IPV disqualification but is still required to
repay overpayment amounts.

(3) A child care provider found to have committed an
intentional program violation (IPV) is ineligible for payment for child care as
follows:

(a) A child care provider with an IPV established
between April 1, 2001 and September 30, 2005 is permanently disqualified to
receive payment.

(b) A child care provider who has incurred an
overpayment established as an IPV claim after September 30, 2005 is ineligible
for payment:

(A) For six months and until the full amount of the
overpayment is paid; or

(B) Permanently, if the Child Care Program Manager
finds that such ineligibility is in the public interest. The following is a
non-exclusive list of reasons that support a determination of permanent
ineligibility: safety concerns; or, the likelihood of future violations; or,
the degree of egregiousness of any of the established IPVs; or, the degree of
primary involvement in the violation by the provider.

(4) In the SNAP and TANF programs, when an IPV is
established against a person through a contested case hearing, a waiver of the
right to hearing, or by a state or federal court:

(a) That person is liable for repayment to the
Department of the full amount of overpayment the Department has established,
regardless of any restitution ordered by a court.

(b) The client is disqualified from receiving benefits
in the program in which the IPV was committed for a period of 12 calendar
months for the first IPV, 24 calendar months for the second IPV and permanently
for the third IPV.

(c) If the TANF grant is affected by the IPV penalty
imposed under this rule, eligibility for and the level of SNAP benefits are
determined in accordance with OAR 461-145-0105.

(5) In the TA-DVS program, when an IPV is established
against a person through a contested case hearing, a waiver of the right to
hearing, or by a state or federal court:

(a) That person is liable for repayment to the
Department of the full amount of overpayment the Department has established,
regardless of any restitution ordered by a court. The Department will seek
repayment from the client only if seeking repayment would not place the client
at greater risk of domestic violence.

(b) Subsequent applications for TA-DVS that meet the
eligibility criteria set forth in OAR 461-135-1215 and 461-135-1225 must be
staffed with the Department’s central office.

(6) A person found by a federal, state, or local court
to have traded a controlled substance for SNAP benefits is disqualified from
participation in the SNAP program as follows:

(a) For a period of two years upon the first occasion.

(b) Permanently upon the second occasion.

(7) A person found by a federal, state, or local court
to have traded firearms, ammunition, or explosives for SNAP benefits is
permanently disqualified from participation in the SNAP program.

(8) A person convicted of an act prohibited by 7 U.S.C.
2024(b) or (c) (1999) involving an item covered by those subsections and having
a value of $500 or more is permanently disqualified from participation in the
SNAP program.

(9) A person is disqualified for a 10-year period from
receiving benefits in the program in which the person committed fraud if the
person:

(a) In the TANF program:

(A) Is convicted in state or federal court of having
made a fraudulent statement or representation with respect to the place of
residence of the individual in order to receive assistance simultaneously from
two or more states under programs that are funded under Title IV or XIX of the
Social Security Act.

(B) Is found in an IPV hearing or admits, in a written
waiver of the right to an IPV hearing, to having made a fraudulent statement or
representation with respect to the identity or place of residence of the
individual in order to receive benefits simultaneously from two or more states.

(b) In the SNAP program, is convicted in state or
federal court, is found in an IPV hearing, or admits in a written waiver of the
right to an IPV hearing, of having made a fraudulent statement or
representation with respect to the identity or place of residence of the
individual in order to receive multiple benefits simultaneously from one or
more states under programs that are funded under the Food Stamp Act of 1977.

(10) The Department issues notice of disqualification
in accordance with OAR 461-175-0220. The disqualification provided for in this
rule begins the first of the month following the month in which the notice
period ends.

(11) Once a disqualification period begins, it
continues uninterrupted until completed, regardless of the eligibility of the
filing group of the disqualified person.

Subject: OAR 461-115-0050 is being amended as part of the
implementation of HB 3536 (2011) to indicate when clients who have had their
medical case suspended as a result of incarceration with an anticipated stay of
one year or less do not need a new application to resume medical benefits.

OAR 461-130-0330
about the disqualification penalty in the Department’s Temporary Assistance for
Needy Families program is being amended to change the levels of
disqualifications and the penalty in the final month in the Job Opportunity and
Basic Skills (JOBS) program. The amendment also adds a two month ineligibility
period if a client does not begin cooperation in the final month of
disqualification. As a result of legislative changes during the 2011
legislative session, the levels and penalty for non- cooperation in the JOBS
program are being changed. The amendment changes the levels of disqualification
from four to two. There are three months in the first level and one month in
the second level. The amendment also stipulates that a client who does not
begin cooperation in the second level month will have the TANF grant closed and
would not be eligible for TANF program benefits for two-consecutive month.

OAR 461-130-0335
about removing a disqualification penalty and the effects on benefits is being
amended to change how a disqualification is ended depending on the level of
disqualification in the Temporary Assistance for Needy Families (TANF) program.
In the first level of disqualification a disqualified individual must cooperate
for two consecutive weeks in all activities of a new or revised case plan. In
the second level of disqualification the disqualified individual must begin the
two consecutive weeks of cooperation prior to the end of the month or their
TANF grant will be closed for two consecutive months. After which the
individual would need to re-apply for TANF program benefits. If the individual
begins and cooperates for the two consecutive months, TANF benefits are
restored effective the date the two consecutive weeks ended. As a result of
legislative changes during the 2011 legislative session, the levels and penalty
for non-cooperation in the JOBS program is being changed. This amendment was
needed to comply with the legislative changes. This rule is also being amended
to clarify the meaning of the term “household”.

OAR 461-135-0089
about the disqualification penalty for non-cooperation with substance abuse and
mental health requirements in the Pre-TANF, Refugee, and TANF programs is being
amended to describe how to end a penalty imposed under OAR 461-135-0085. The
amendment specifies what a client must do in order to end a disqualification
imposed under OAR 461-135-0085. These changes are a result of legislative
changes during the 2011 legislative session, changing the levels and penalty
for non- cooperation in the JOBS program.

OAR 461-135-0485
is being adopted to implement HB 2049 (2011) by setting out the requirements to
complete an employability assessment and orientation for the Job Opportunity
and Basic Skills (JOBS) program. These are new requirements for individuals
applying for the Temporary Assistance to Need Families (TANF) program.

OAR 461-135-0950
is being amended as part of the implementation of HB 3536 (2011) to state that
clients who become incarcerated for less than 12 months may have their medical
benefits suspended rather than closed. This legislation was based on a request
by local jails that have been experiencing an influx of inmates with high
medical needs. These inmates have had their medical benefits terminated upon
incarceration, and were not able to get their benefits reinstated upon release
without completing a new application and/or submitting a reservation list
request for OHP benefits. Reinstating medical benefits without a new
application when an individual reports their release timely result in more
timely medical benefits. This rule is also being amended to include the age
criteria previously in OAR 461-135-0960 for individuals in state psychiatric
institutions and training centers for the Oregon Supplemental Income Program
Medical (OSIPM) and Medical Coverage for Children in Substitute or Adoptive
Care (SAC) programs.

OAR 461-135-0960
about the age criteria for individuals in state psychiatric institutions and
training centers for the Oregon Supplemental Income Program Medical (OSIPM) and
Medical Coverage for Children in Substitute or Adoptive Care (SAC) programs is
being suspended as part of the implementation of HB 3536 (2011) to make the
rules about suspension of benefits easier to understand and follow. This topic
will be included in OAR 461-135-0950.

OAR 461-135-1195
about the specific eligibility requirements for the Department’s State Family
Pre-SSI/SSDI (SFPSS) program is being amended to expand eligibility to
one-adult families with each child in the household are on Social Security
Income (SSI). As a result of budget reductions during the 2011 legislative
session, the SFPSS grants are being reduced by removing enhanced grants. The
grant will equal what the clients would have been receiving in a Temporary
Assistance for Needed Families (TANF) grant. Because of this change, families
with one adult where their child or all their children in the household are
receiving SSI will have an SFPSS grant equal to a TANF grant. Prior to the
grant amount changing, these families would have received less on SFPSS than
TANF. Therefore they were not allowed to be on SFPSS program. They were
provided all other SFPSS services.

OAR 461-135-1260
is being adopted to set out the specific requirements of the Job Participation
Incentive (JPI) program, which is part of the strategy to meet federal
requirements related to TANF participation and help increase the ability of
single parents with small children provide better nutrition to their families.

OAR 461-145-0410
about how program benefits are treated in the eligibility process is being
amended to provide specifics regarding description of the Job Participation
Incentive (JPI) program benefits and how those benefits will be treated when
determining eligibility for other programs.

OAR 461-160-0015
is being amended to update the resource limit for SNAP households that include
at least one member who is elderly or an individual with a disability. The
resource limit for these SNAP households prior to October 1, 2011 was $3,000.
Based on an in increase in the Consumer Price Index (CPI) the new resource
limit as of October 1, 2011 is $3,250. There is no change in the resource limit
for other SNAP households.

OAR 461-170-0011
is being amended to set out the reporting requirements for clients in the Job
Participation Incentive (JPI) program, aligning these requirements with SNAP
cases in SRS.

OAR 461-180-0050
about effective date for suspending or closing benefits or Job Opportunity and
Basic Skills (JOBS) support services is being amended to fix a conflict between
two rules and correct an error applicable to TANF program notices, changing the
reference to the notice period from 30 to 45 days. This rule is also being
amended as part of the implementation of HB 3536 (2011) to set out the policy
on the effective date for suspending benefits for inmates.

OAR 461-180-0070
about effective dates for initial month of benefits is being amended to clarify
the initial date for TANF benefits when a client has received Pre-TANF benefits
in the context of other changes to the Pre-TANF program due to state
legislation and budget constraints.

Rules Coordinator: Annette Tesch—(503) 945-6067

461-115-0050

When an Application Must Be Filed

(1) A client must file an application, or may amend a
completed application, as a prerequisite to receiving benefits as follows:

(a) A client may apply for the TA-DVS program as
provided in OAR 461-135-1220.

(b) In all programs except the TA-DVS program:

(A) Except as provided otherwise in this rule, a client
wishing to apply for program benefits must submit a complete application on a
form approved by the Department.

(B) An application is complete if all of the following
requirements are met:

(i) All information necessary to determine the
individual’s eligibility and benefit amount is provided on the application for
each individual in the filing group.

(ii) The applicant, even if homeless, provides a
mailing address.

(iii) The application is signed. An individual required
but unable to sign the application may sign with a mark, witnessed by another
individual.

(iv) The application is received by the Department,
except an electronic application (see OAR 461-001-0000) meets the requirements
of this paragraph only when submitted to and received by the Department with an
electronic signature.

(2) A new application is not required in the following
situations:

(a) In the SNAP program, when a single application can
be used both to determine a client is ineligible in the month of application
and to determine the client is eligible the next month. This can be done when:

(A) Anticipated changes make the filing group (see OAR
461-110-0370) eligible the second month; or

(B) The filing group provides verification between 30
and 60 days following the filing date (see OAR 461-115-0040), under OAR
461-180-0080.

(b) In all programs except the SNAP program, when a
single application can be used both to determine a client is ineligible on the
date of request (see OAR 461-115-0030) and to determine the client is eligible
when anticipated changes make the filing group eligible within 45 days from the
date of request.

(c) When the case is closed and reopened during the
same calendar month.

(d) When benefits were suspended for one month because
of the level of income, and the case is reopened the month following the month
of suspension.

(e) When reinstating medical benefits for a pregnant
woman covered by OAR 461-135-0950, notwithstanding subsection (g) of this
section.

(f) When the Department determines a child under the
age of 19 years with a date of request from July 1, 2009 through December 31,
2009 is not eligible for EXT, MAA, MAF, OHP, OSIPM, QMB, or SAC program
benefits for a reason other than failure to complete the application
requirements under OAR 461-115-0020, and the Department chooses to redetermine
the child’s eligibility for EXT, MAA, MAF, OHP, OSIPM, QMB, and SAC program
benefits under the administrative rules in effect on October 1, 2009 and
January 1, 2010.

(g) In the BCCM, CEC, CEM, EXT, GAM, MAA, MAF, OHP,
OSIPM, QMB, and SAC programs, when a client’s medical benefits are suspended
because the client lives in a public institution (see OAR 461-135-0950), no new
application is required if the inmate is released within 12 months of admission
and the inmate provides notification to the Department within 10 days of the
release.

(3) When a client establishes a new date of request
(see OAR 461-115-0030) prior to the end of the month following the month of
case closure, unless the Department determines a new application is required, a
new application is not required in the following situations:

(a) In the OSIPM program, when the client’s case closed
due to failure to make a liability payment required under OAR 461-160-0610.

(b) In the OSIPM-EPD program, when the client’s case
closed due to failure to make a participant fee payment required under OAR
461-160-0800.

(4) A new application is required to add a newborn
child to a benefit group (see OAR 461-110-0750) according to the following
requirements:

(a) For the REF and TANF programs:

(A) A new application is not required if the child is
listed on the application as “unborn” and there is sufficient information about
the child to establish its eligibility.

(B) A new application is required if the child is not
included on the application as “unborn.”

(b) In the CEC, CEM, EXT, HKC, MAA, MAF, OHP, and REFM
programs, no additional application is required to add a newborn to a benefit
group receiving benefits from one of the listed programs if eligibility can be
determined without submission of a new application.

(c) In the CEC, CEM, EXT, GAM, HKC, MAA, MAF, OHP,
OSIPM, QMB, REFM, and SAC programs, no additional application is required to
add an assumed eligible newborn to a benefit group currently receiving
Department medical program benefits.

(d) In the ERDC and SNAP programs, an application is
not required to add the child to the benefit group.

(5) A new application is required to add an individual,
other than a newborn child, to a benefit group according to the following
requirements:

(a) In the ERDC and SNAP programs, a new application is
not required.

(b) In the EXT, HKC, MAA, MAF, OHP, REF, REFM, SAC, and
TANF programs, an individual may be added by amending a current application if
the information is sufficient to determine eligibility; otherwise a new
application is required.

(c) In all programs other than the ERDC, EXT, HKC, MAA,
MAF, OHP, REF, REFM, SAC, SNAP, and TANF programs, a new application is
required.

(6) A client whose TANF grant is closing may request
ERDC orally or in writing.

(7) Except for an applicant for the SNAP program, a
client may change between programs administered by the Department using the
current application if the following conditions are met:

(a) The client makes an oral or written request for the
change.

(b) The Department has sufficient evidence to determine
eligibility and benefit level for the new program without a new application.

(c) The program change can be effected while the client
is eligible for the first program.

(8) In the CEC, CEM, EXT, HKC, MAA, MAF, OHP, OSIP,
OSIPM, and QMB programs, a new application is not required to redetermine
eligibility if the following conditions are met:

(a) The client currently is receiving benefits from one
of these programs; and

(b) The Department has sufficient evidence to
redetermine eligibility for the same program or determine eligibility for the
new program without a new application or by amending the current application.

(1) In the Post-TANF, Pre-TANF, REF, SNAP, and TANF
programs, the Department may not disqualify from program benefits a client who
is a volunteer (see OAR 461-130-0305) participant in an employment program.

(2) In the Pre-TANF, REF, and TANF programs, a mandatory
(see OAR 461-130-0305) client who fails to comply with an employment program
participation requirement and does not have good cause (see OAR 461-130-0327)
for the failure to comply is subject to disqualification under this rule only
after the requirements of all of the following subsections are met:

(a) The client has had the opportunity to participate
in the re-engagement process under OAR 461-190-0231;

(b) The Department has determined the client is
willfully non-compliant and does not have good cause for failing to comply with
a requirement of the program;

(c) The Department has offered (and the client has
refused) or conducted screenings (and assessed if appropriate) for physical or
mental health needs, substance abuse, domestic violence, and learning needs;

(d) The Department has determined the client has no
barriers (see OAR 461-001-0025) or refuses to take appropriate steps to address
identified barriers;

(e) The Department has determined the client has not
met federally required participation rates (see OAR 461-001-0025); and

(f) The Department has assessed for any risk of harm
posed to the children by a reduction in cash assistance.

(3) In the REF and TANF programs, the effects of a JOBS
disqualification are progressive. There are two levels of disqualification.
Once a disqualification is imposed, it affects benefits according to the
following schedule until the disqualification ends in accordance with OAR
461-130-0335:

(a) At the first level, the penalty is removal of the
disqualified client from the need group (see OAR 461-110-0630) for three
months.

(b) At the second level, the need group receives no
cash benefit in the program for one month.

(c) At the end of the second level, program benefits
are closed and the filing group may not receive program benefits for the
following two consecutive months. This may be prevented if the disqualified
client:

(A) Contacts a representative of the Department in
order to re-engage in the JOBS program prior to the end of the second level;
and

(B) Begins the two consecutive weeks of cooperation as
outlined in section (4) of OAR 461-130-0335 prior to the end of the second
level; or

(C) Is no longer a member of the household group (see
OAR 461-110-0210 and 461-130-0335(2)); or

(D) Is unable to participate because there are no
appropriate activities (see OAR 461-001-0025) or support services (see OAR
461-001-0025) necessary to support the activity (see OAR 461-001-0025).

(4) In the SNAP program:

(a) A mandatory client who fails to comply with the
requirements of an employment program is subject to disqualification. A
disqualified client is removed from the need group until he or she meets the
employment program requirements and serves the applicable progressive
disqualification under the following subsections:

(A) One calendar month for the first failure to comply.

(B) Three calendar months for the second failure to
comply.

(C) Six calendar months for the third and subsequent
failures to comply.

(b) A client who is exempt (see OAR 461-130-0305) from
participation in the SNAP employment program because he or she is a mandatory
participant in the JOBS program, receiving unemployment compensation benefits,
or has applied for unemployment compensation benefits and is waiting on an
initial decision must comply with the requirements of those programs. If the
client fails to comply with the requirements of the applicable program the
client is disqualified from receiving SNAP benefits, unless he or she can show
good cause under OAR 461-130-0327.

(1) An applicant who would be subject to an employment
program disqualification under OAR 461-130-0330 but withdraws the application
before benefits are approved is not subject to disqualification.

(2) In the SNAP and TANF programs, a filing group (see
OAR 461-110-0330 and 461-110-0370) is not subject to the impact of a
disqualification for a disqualified member who has left the household group
(see OAR 461-110-0210). Should the member join another filing group, that group
is subject to the member’s most recent disqualification.

(3) In the SNAP program, the disqualification ends the
first day of the month following the month in which information is provided to
the Department justifying the change in the client’s participation
classification, even if the date falls within the disqualification period
provided in OAR 461-130-0330(4).

(4) In the REF and TANF programs, a client disqualified
for failure to meet the requirements of an employment program under division
190 of these rules:

(a) At the first level of disqualification must
cooperate for two consecutive weeks with each activity (see OAR 461-001-0025)
specified in the client’s current or revised case plan (see OAR 461-001-0025)
before the Department may remove the disqualification. Cash benefits are restored
effective the date the client completes the two consecutive week cooperation
period.

(b) When the second level of disqualification ends,
TANF program benefits are closed for two consecutive months, unless the client
begins two consecutive weeks of cooperation with each activity specified in the
client’s current or revised case plan before the end of the level two. If the
client completes the two consecutive weeks of cooperation, cash benefits are
restored effective the date the client completes the two consecutive week
cooperation period.

(c) Cash benefits shall be restored effective the date
it is determined, by the Department, there are no appropriate activities or
support services (see OAR 461-001-0025) necessary to support the activity
available in order for the client to demonstrate participation.

(5) In the REF and TANF programs, a disqualification
ends when the Department changes the participation classification of the
disqualified individual to exempt (see OAR 461-130-0305) or when the client
complies with the requirements of the employment program (see section (4) of
this rule).

(a) At the first level of disqualification (see OAR
461-130-0330(3)), a client must:

(A) Cooperate for a period of two consecutive weeks
with each activity (see OAR 461-001-0025) specified in the client’s current or
revised case plan (see 461-001-0025); and

(B) Demonstrate a willingness to participate in
treatment required under OAR 461-135-0085 if treatment is still required.

(b) When the second level of disqualification (see OAR
461-130-0330(3)) ends, program benefits are closed for two consecutive months,
unless the client:

(A) Begins two consecutive weeks of cooperation with
each activity specified in the client’s case plan before the end of the level
two; and

(B) Demonstrates a willingness to participate in
treatment required under OAR 461-135-0085 if treatment is still required.

(2) When the Department removes a disqualification due
to a client’s compliance with the requirements under OAR 461-135-0085, cash
benefits are restored effective the date the client completed the two consecutive
week cooperation period.

(b) “Overview of the JOBS program” means a discussion
with the caretaker relative (see OAR 461-001-0000) in the need group (see OAR
461-110-0630) about the requirements and services provided under the JOBS
program.

(2) To be eligible for TANF benefits, the following
must be completed prior to the end of the application processing time frames in
OAR 461-115-0190:

(a) Each caretaker relative in the need group must
complete an employability screening (see section (1) of this rule); and

(b) At least one caretaker relative in the need group
must participate in an overview of the JOBS program (see section (1) of this
rule).

(3) The employability screening and overview of the
JOBS program must be offered during the initial eligibility intake for TANF
program benefits.

(1) This rule sets out additional restrictions on the
eligibility of inmates and residents of state hospitals for programs covered by
Chapter 461 of the Oregon Administrative Rules.

(2) Definition of an “inmate”.

(a) An inmate is an individual living in a public
institution who is:

(A) Confined involuntarily in a local, state or federal
prison, jail, detention facility, or other penal facility, including an
individual being held involuntarily in a detention center awaiting trial or an
individual serving a sentence for a criminal offense;

(B) Residing involuntarily in a facility under a
contract between the facility and a public institution where, under the terms
of the contract, the facility is a public institution;

(C) Residing involuntarily in a facility that is under
governmental control; or

(D) Receiving care as an outpatient while residing
involuntarily in a public institution.

(b) An individual is not considered an inmate when:

(A) The individual is released on parole, probation, or
post-prison supervision;

(B) The individual is on home- or work-release, unless
the individual is required to report to a public institution for an overnight
stay;

(C) The individual is staying voluntarily in a
detention center, jail, or county penal facility after his or her case has been
adjudicated and while other living arrangements are being made for the
individual; or

(D) The individual is in a public institution pending
other arrangements as defined in 42 CFR 435.1010.

(3) Definition of a “public institution”.

(a) A public institution is any of the following:

(A) A state hospital (see ORS 162.135).

(B) A local correctional facility (see ORS 169.005): a
jail or prison for the reception and confinement of prisoners that is provided,
maintained and operated by a county or city and holds individuals for more than
36 hours.

(C) A Department of Corrections institution (see ORS
421.005): a facility used for the incarceration of individuals sentenced to the
custody of the Department of Corrections, including a satellite, camp, or
branch of a facility.

(D) A youth correction facility (see ORS 162.135):

(i) A facility used for the confinement of youth
offenders and other individuals placed in the legal or physical custody of the
youth authority, including a secure regional youth facility, a regional
accountability camp, a residential academy and satellite, and camps and branches
of those facilities; or

(ii) A facility established under ORS 419A.010 to
419A.020 and 419A.050 to 419A.063 for the detention of children, wards, youth,
or youth offenders pursuant to a judicial commitment or order.

(b) As used in this rule, the term public institution
does not include:

(A) A medical institution as defined in 42 CFR 435.1010
including the Secure Adolescent Inpatient Program (SAIP) and the Secure
Children’s Inpatient Program (SCIP);

(B) An intermediate care facility as defined in 42 CFR
440.140 and 440.150;

(C) A publicly operated community residence that serves
no more than 16 residents, as defined in 42 CFR 435.1009; or

(D) A child-care institution as defined in 42 CFR
435.1009 with respect to:

(i) Children for whom foster care maintenance payments
are made under title IV-E of the Social Security Act; and

(ii) Children receiving TANF-related foster care under
title IV-A of the Social Security Act.

(4) Definition of serious mental illness. An individual
has a serious mental illness if the individual has been diagnosed by a
psychiatrist, a licensed clinical psychologist or a certified non-medical
examiner as having dementia, schizophrenia, bipolar disorder, major depression
or other affective disorder or psychotic mental disorder other than a substance
abuse disorder and other than a disorder that is both:

(a) Caused primarily by substance abuse; and

(b) Likely to no longer meet the applicable diagnosis
if the substance abuse discontinues or declines.

(5) An individual who resides in a public institution,
meets the definition of a serious mental illness (see section (4) of this
rule), and applies for medical assistance between 90 and 120 days prior to the
expected date of the person’s release from the public institution may be found
eligible for medical assistance. If the individual is determined to be
eligible, the effective date of the individual’s medical assistance is the date
the individual is released from the institution.

(6) A client who becomes a resident of a state hospital
has medical benefits suspended for up to twelve full calendar months if the
client is at least 22 years of age and under 65 years of age. When a client
with suspended medical benefits is no longer a resident of the state hospital,
medical benefits are reinstated effective the first day the client is no longer
a resident, if the client continues to meet eligibility for the medical
program.

(7) An individual residing in a state psychiatric
institution may be eligible for OSIPM or SAC benefits if the individual is:

(a) 65 years of age or older;

(b) Under 22 years of age; or

(c) 21 years of age or older, if the basis of need is
disability or blindness; eligibility was determined before the individual
reached 21 years of age; and the individual entered the state hospital before
reaching 21 years of age.

(8) For all programs covered under chapter 461 of the
Oregon Administrative Rules:

(a) Except as provided in OAR 461-135-0750, an inmate
of a public institution is not eligible for benefits.

(b) If a pregnant woman receiving medical assistance
through the BCCM, CEC, CEM, EXT, GAM, MAA, MAF, OHP, OSIPM, or SAC program
becomes an inmate of a public institution, her medical benefits are suspended.
When the Department is informed the woman is no longer an inmate, her medical benefits
are reinstated--effective on the first day she is no longer an inmate--if she
is still in her protected period of eligibility under OAR 461-135-0010.

(c) If an individual receiving medical assistance
through the BCCM, CEC, CEM, EXT, GAM, MAA, MAF, OHP, OSIPM, QMB, or SAC program
becomes an inmate of a correctional facility with an expected stay of no more
than 12 months, medical benefits are suspended for up to 12 full calendar
months during the incarceration period.

(A) In the BCCM, CEC, CEM, EXT, GAM, MAA, MAF, OHP, or
SAC program, when the Department is notified by a client with suspended
benefits that the client has been released from incarceration, and the
notification takes place within 10 days of the release or there is good cause
for the late reporting, medical benefits are reinstated effective the first day
the client is no longer an inmate.

(B) In the OSIPM or QMB program, when the Department is
notified that an individual with suspended benefits has been released, and the
notification takes place within 10 days of the release, medical benefits are
reinstated effective the first day the client is no longer an inmate if the
client continues to meet eligibility for the medical program.

(9) In the GA and SNAP programs, in addition to the
other provisions of this rule, an inmate released from a public institution on
home arrest, and required to wear an electronic device to monitor his or her
activity, is ineligible for benefits if the correctional agency provides room
and board to the individual.

Age Criteria for Individuals in
State Psychiatric Institutions and Training Centers; OSIPM, SAC

(1) Individuals residing in state psychiatric
institutions (Blue Mountain Recovery Center, Oregon State Hospital, or the
Portland Oregon State Hospital) may be eligible for OSIPM or SAC benefits if
they are:

(a) Sixty-five years of age or older;

(b) Under 21 years of age; or

(c) Twenty-one years of age or older, if the basis of
need is disability or blindness; eligibility was determined before the client
reached 21 years of age; and the individual entered the institution before
reaching 21 years of age.

(2) There is no age limit for individuals in the state
training center (Eastern Oregon Training Center which is an intermediate care
facility for the mentally retarded or ICF/MR) to be eligible for OSIPM or SAC.

(b) Meet all TANF program eligibility requirements
(except as provided otherwise in this rule);

(c) Be receiving TANF benefits;

(d) Have an impairment that meets the requirements in
OAR 461-125-0260;

(e) File an application for Supplemental Security
Income (SSI) disability benefits under the Social Security Act; and

(f) Sign an Interim Assistance Authorization
authorizing the Department to recover interim SFPSS program benefits paid to
the client (or paid to providers on the client’s behalf) from the initial SSI
payment or the initial payment after the decision on SSI eligibility. The
following provisions are considered part of the Interim Assistance
Authorization:

(A) Interim SFPSS program benefits include only those
SFPSS program cash benefits paid to the adult, who is applying for SSI, during
the period of time that the SSI benefit covers.

(B) For any month in which SSI is prorated, the
Department may recover only a prorated amount of the interim SFPSS program cash
benefit.

(C) If the Department does not stop delivery of an
SFPSS program benefit issued after the SSI payment is made, the SFPSS program
payment is included in the interim assistance reimbursement to the Department.

(2) Counting earned and unearned income.

(a) The TANF standards in OAR 461-155-0030 are used to
determine eligibility for the SFPSS program.

(b) The SFPSS payment standard (see OAR 461-155-0320)
is used to determine the benefit amount for the SFPSS program.

(3) A client whose impairment no longer meets the
criteria in OAR 461-125-0260 is ineligible for SFPSS benefits.

(4) An SFPSS client found by the Social Security
Administration (SSA) not to meet disability criteria may continue receiving
SFPSS benefits until all SSA administrative appeals are exhausted.

(5) Once a client is approved for SFPSS, the client is
no longer subject to OAR 461-120-0340. The client remains exempt from
461-120-0340 as long as the client is eligible for and receiving SFPSS.

(6) Each client is required to participate in the
appropriate activities the Department determines necessary, including
activities that promote family stability (see OAR 461-001-0000). The Department
must consider the needs of an individual with a disability (see 461-001-0000),
and a client’s need for accommodation or modification.

(7) A client must provide the information necessary for
the Department to administer the program.

(a) The necessary information includes that needed to
determine appropriate activities for the client and to assess whether a client
had good cause (see OAR 461-130-0327) for any failure to meet a requirement of
the program.

(b) If a medical condition is in question, the
Department will assist and may require the client to provide a medical opinion
from a qualified and appropriate medical professional.

(8) The Department offers each client the opportunity
to participate in any suitable JOBS program activity (see OAR 461-001-0025).

(2) Starting October 1, 2011, an individual eligible
for the JPI program may receive a $10 monthly food benefit.

(a) The individual receives the $10 incentive payment
starting the month the Department receives documentation that all enrollment
criteria in section (3) of this rule have been met.

(b) There are no partial months of JPI benefits.

(c) The individual may only be issued retroactive JPI
benefits as allowed under OAR 461-180-0130.

(3) To enroll in the JPI program, an individual must:

(a) Be working at an unsubsidized paid employment
equivalent to 20 weekly hours at Oregon State minimum wage;

(b) Provide the Department with employer-produced
documents of paid, unsubsidized work hours covering a consecutive two-week
period that has occurred within the last 60 days;

(c) Have reason to anticipate the same weekly
employment hours will remain the same for the reporting period;

(d) Provide employer-produced documents of paid,
unsubsidized work hours each time requested by the Department or no later than
the last day of the sixth month following the date the client provides the
verification of work hours in accordance with subsections (a) and (b) of this
section;

(e) Meet citizenship requirements to be an adult in the
SNAP benefit group (see OAR 461-110-0750);

(f) Be an eligible adult in a SNAP benefit group (see
OAR 461-110-0750) and the sole parent of an eligible dependent child (see OAR
461-001-0000) under age six in the same SNAP benefit group; and

(g) Not be receiving Post-TANF, SFPSS, and TANF
programs in the same month.

(4) Payments from the JPI (see OAR 461-135-1260) are
issued as a food benefit and are excluded for all programs.

(5) SNAP payments are treated as follows:

(a) The value of an SNAP benefit is excluded in all
programs except the EA program. In the EA program, the value is counted as a
resource when determining the emergency food needs of the filing group (see OAR
461-110-0310).

(a) In the EA program, these payments are counted as
unearned income, except that these payments are excluded for a benefit group
(see OAR 461-110-0750) whose emergent need is the result of domestic violence
(see 461-001-0000).

(b) In the ERDC program:

(A) Post-TANF payments are excluded.

(B) All other payments are counted as unearned income.

(c) In the SNAP program:

(A) These payments are treated as unearned income.

(B) An amount received as a late processing payment is
treated as lump-sum income.

(C) Payments made to correct an underpayment are
treated as lump-sum income.

(D) Ongoing special needs payments for laundry
allowances, special diet or meal allowance, restaurant meals, accommodation
allowances, and telephone allowances are treated as unearned income. All other
special needs payments are excluded as reimbursements.

(d) In the OHP program:

(A) GA payments are excluded from income for purposes
of determining OHP eligibility.

(i) The payments are counted as unearned income if all
the individuals included in the benefit group for the cash payment are also in
the OHP financial group (see OAR 461-110-0530).

(ii) A prorated share is counted as unearned income if
any of the individuals in the cash payment are not included in the OHP
financial group. A prorated share is determined by dividing the total payment
by the number of individuals in the TANF benefit group.

(iii) A payment made to correct an underpayment caused
by the Department is excluded if the underpayment occurred prior to the budget
period.

(e) In all programs except the EA, ERDC, OHP, and SNAP
programs:

(A) These payments are excluded in the month received,
and any portion remaining following the month of receipt is counted as a
resource.

(B) Payments made to correct an underpayment are
excluded.

(f) In all programs:

(A) JOBS, REF, and TANF JOBS Plus support service
payments are excluded.

(a) $10,000 for a need group with at least one JOBS
participant who is progressing in a case plan.

(b) $10,000 for a need group with at least one member
who is working under a JOBS Plus agreement.

(c) $2,500 for all other need groups, including all
TANF applicants.

(5) In the OHP program, the resource limit for an
individual whose eligibility is determined under the OHP-OPU program is $2,000.

(6) In the QMB program, the resource limit is amended
in January of each year based on the low income subsidy for Medicare Part D as
published by the Health Resources and Services Administration of the U.S.
Department of Health and Human Services. Effective January 1, 2011 the resource
limit is $6,680 for a one-person need group and $10,020 for a need group
containing two or more individuals.

(7) In the SNAP program, the resource limit is:

(a) $3,250 for a financial group (see OAR 461-110-0530)
with at least one member who is elderly (see OAR 461-001-0015) or an individual
with a disability (see OAR 461-001-0015).

Effective Dates; Suspending or
Closing Benefits and JOBS Support Service Payments

(1) This rule explains the effective date for closing
or suspending benefits for the entire benefit group (see OAR 461-110-0750) and
the effective date for ending JOBS support service payments.

(2) In all programs except the ERDC program, when the
only individual in a benefit group dies, the effective date of the closure is:

(a) In the REF, SNAP, and TANF programs, the last day
of the month in which the death occurred.

(b) In all other programs, the date of the death.

(3) For all closures and suspensions not covered by
section (2) of this rule, the effective date is determined as follows:

(a) When prospective eligibility is used, the effective
date for closing or suspending benefits is the last day of the month in which
the notice period ends.

(b) When retrospective eligibility or budgeting is
used, the effective date for closing or suspending benefits is the last day of
the budget month.

(c) When an absent parent enters an ongoing TANF program
household, or another change occurs that ends eligibility based on the
incapacity or unemployment of a parent, the effective date for closing benefits
is the last day of the month in which the 45-day period described in OAR
461-125-0255 ends.

(d) For a pregnant female receiving benefits of the
EXT, MAA, MAF, OSIPM, or SAC program, the effective date for closing benefits
is no earlier than the last day of the calendar month in which the 60th day
after the last day of pregnancy falls, except at the client’s request.

(e) Notwithstanding subsection (f) of this section, for
a client who is receiving medical assistance and becomes incarcerated with an
expected stay of a year or less, the effective date for suspending medical
benefits is the effective date on the decision notice (see OAR 461-001-0000).

(f) In the OHP program, the effective date for closing
benefits is:

(A) The last day of the month in which the benefit
group becomes ineligible;

(B) The date the program ends; or

(C) For cases not covered by paragraph (A) or (B) of
this subsection, the last day of the certification period (see OAR
461-001-0000).

(g) The effective date for ending support service
payments authorized under OAR 461-190-0211 is the earlier of the following:

(A) The date the related JOBS activity is scheduled to
end.

(B) The date the client no longer meets the
requirements of OAR 461-190-0211.

(1) In the EA program, the effective date for opening
the case is the day benefits are issued to the benefit group (see OAR
461-110-0750). For a benefit group whose only eligible child is an unborn, the
effective date cannot be earlier than the first day of the calendar month
preceding the month in which the due date falls.

(2) In the ERDC program, the effective date for
starting benefits is one of the following:

(a) The first day of the month in which the request for
benefits is made, as long as:

(A) All eligibility requirements are met in that month;
and

(B) Verification is provided within the application
processing timeframes.

(b) If all eligibility requirements are not met in the
month of request, the effective date is the first day of the month in which
they are met, if verification is provided within the application processing
timeframes.

(c) For a benefit group that received TANF program
benefits within the 30 days before applying for ERDC program benefits, the
effective date is the first of the month following closure of their TANF
program benefits.

(3) In the GA program, the effective date for the
initial month (see OAR 461-001-0000) of benefits is whichever of the following
occurs first:

(a) The day all eligibility requirements are met and
verified.

(b) The 45th day from the date the client requests
benefits, if all eligibility r